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Arquivos de Neuro-Psiquiatria

Print version ISSN 0004-282X

Arq. Neuro-Psiquiatr. vol.51 no.3 São Paulo Sept. 1993

http://dx.doi.org/10.1590/S0004-282X1993000300007 

Neurocisticercosis en un hospital de la ciudad de Buenos Aires: estudio de once casos

 

Neurocysticercosis in Buenos Aires: a study of eleven patients in a metropolitan hospital

 

 

A. M. Villa; D. A. Monteverde; W. Rodriguez; A. Boero; R. E. P. Sica

Division Neurologia, Hospital Ramos Mejia, Catedra de Neurologia, Facultad de Medicina, Universidad de Buenos Aires

 

 


RESUMEN

Fueron examinados 11 pacientes adultos con el diagnostico presuntivo de neuro-cisticercosis, 8 de ellos provenientes de Bolivia y los restantes del interior de la Argentina. Como manifestacion clinica inicial el 82% de ellos mostro convulsiones y el 73% cefaleas. Ambas alteraciones podían estar combinadas en el mismo paciente o presentarse en forma independiente. La tomografia computada de cerebro evidencio calcificaciones y quistes en 5 enfermos, solo calcificaciones en 3, hidrocefalia en 2 y un unico quiste en 1. En 7 casos se efectuo ELISA en el LCR, de ellos 6 resultaron positivos. El tratamiento medico se hizo en base a la administración de praziquantel o albendazol con buena evolución de los pacientes en todos los casos. El tratamiento quirúrgico fue indicado solo en el caso en que una lesion actuase como masa ocupante con aumento de la presión endocraneana (1 caso) o produjera obstruccion de la circulacon del LCR llevando a una hidrocefalia (2 casos). El estudio presente pretende alertar sobre la posibilidad que nuevas regiones, como la Ciudad de Buenos Aires, puedan ingresar dentro del area endemica latinoamericana a consecuencia de los movimientos migratorios internos y externos y el asentamiento de portadores de la parasitosis en el perimetro urbano.

Palabras claves: cisticercosis, sistema nervioso central, neurocisticercosis.


SUMMARY

Eleven patients with diagnosis of possible neurocistycercosis were studied in our Department since 1986. All of them were adults. Eight were Bolivian citizens. The commonest neurological clinical manifestation were seizures and/or headache. Brain CT scans showed cystic lesions and calcifications in 5 patients, only calcifications in 3, enlarged ventricles in 2 and an isolated frontal cystic lesion in 1. Six out of 7 patients who were submitted to spinal fluid ELISA test showed positive response for cysticercosis. Patients were put on praziquantel (50mg/Kg/d) or albendazol (15mg/Kg/d) with good outcome for all them. Surgery was carried on for treatment of enlarged ventricles (2 patients) and for a like-expansive lesion (1 patient). The aim of this work is to underscore the fact that in Buenos Aires city, which previously was not within the endemic latinamerican area for cysticercosis, is now possible to find patients with the neurological manifestations of this parasitosis, most probably due to migration of people coming from the north provinces or from countries situated at its border where the disease is endemic.

Key words: cysticercosis, central nervous system, neurocysticercosis.


 

 

Full text available only in PDF format.

Texto completo disponível apenas em PDF.

 

 

REFERENCIAS

1. Canelas HM. Neurocisticercose: incidencia, diagnostico y formas clinicas. Arq Neuropsiquiatr 1962, 20:1-16.         [ Links ]

2. Flisser A. Neurocysticercosis in Mexico. Parasitology Today 1988, 4:131-137.         [ Links ]

3. Lynn D, Locke G, Byrd S, Daryabagy J. Cerebral cysticercosis: documentation of natural history with CT. Radiology 1989, 171:449-452.         [ Links ]

4. Scharf D. Neurocysticercosis: 238 cases from a California Hospital. Arch Neurol 1988, 45:777-780.         [ Links ]

5. Sotelo J, Guerrero V, Rubio F. Neurocysticercosis, a new classification based on activated and inactivated forms: a study of 753 cases. Arch Intern Med 1985, 145:442-445.         [ Links ]

5. Villa A, Monteverde MA, Rodriguez W, Boero A, Sica REP. Neurocisticercosis en Argentina. VIII Congreso Panamericano de Neurologia. Montevideo, 1991.         [ Links ]

 

 

Aceite: 26-janeiro-1993.

 

 

Dr. Andres Villa — Division Neurologia, Hospital Ramos Mejia - Urquiza 609 - 1221 Buenos Aires - Argentina.

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