Browsing by Author "Romo, Matthew L."

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Comparison of complementary diagnostic tests in cerebrospinal fluid and serum for neurocysticercosis
(2018) Romo, Matthew L.; Carpio Rodas, Luis Arturo; Parkhouse, Robert Michael; Cortéz, María Milagros; Rodríguez Hidalgo, Richar
The role of immunologic tests in the diagnosis of neurocysticercosis (NC) is controversial and few studies have made comparisons among them. The objective of this study was to compare immunological tests in both serum and cerebrospinal fluid (CSF) for the diagnosis of NC. We conducted a case-control study in Cuenca, Ecuador, enrolling patients with NC (N = 24) and matching them with other neurosurgical patients (N = 18). To detect cysticercal antigen, we used an HP10 antigen assay in serum and CSF (“HP10 Ag -serum -CSF”) and a commercial antigen assay in serum (apDia, “ELISA-Ag-serum”), and to detect cysticercal DNA, we used a polymerase chain reaction (PCR) assay in CSF (“PCR-CSF”). Assay sensitivities were HP10 Ag-serum (41.7%, 95% confidence interval [CI] 22.1–63.4), HP10 Ag-CSF (87.5%, 95% CI: 67.6–97.3), ELISA-Ag-serum (62.5%, 95% CI: 40.6–81.2), and PCR-CSF (79.2%, 95 …
Exploring the complex associations over time among albendazole treatment, cyst evolution, and seizure outcomes in neurocysticercosis
(2019) Zhang, Hongbin
Wiley Periodicals, Inc. © 2019 International League Against Epilepsy Objective: To develop a causal model for the occurrence of neurocysticercosis (NC)-related seizures and test hypotheses generated from the model. Methods: We used data from a randomized controlled trial comparing albendazole with placebo among patients newly diagnosed with NC. Based on our causal model, we explored the associations among albendazole treatment, NC cyst evolution, and seizure outcomes over 24 months of follow-up using generalized linear mixed effect models. Results: We included 153 participants, of whom 51% received albendazole. The association between seizure outcomes and treatment over time demonstrated lack of linearity and heterogeneity, requiring the inclusion of time-treatment interaction terms for valid modeling. Participants in the albendazole group had fewer seizures overall and of partial onset at all time points compared with the placebo group, but the difference increased over the first few months following treatment, then decreased over time. Generalized seizures exhibited a more complex association; those in the albendazole group had fewer seizures compared with those in the placebo group for the first few months after treatment, and then the association reversed and those in the placebo arm had fewer seizures. Adjusting for the number of NC cysts in each phase resulted in an attenuation of the strength of association between albendazole and seizure outcomes, consistent with mediation. Among participants in whom all cysts had disappeared (n = 21), none continued to have seizures. Significance: Albendazole treatment is associated with a possible reduction in focal seizures in the short term (3-6 months), perhaps by hastening the resolution of the cysts. However, the effect is not discernible over the long term, because most cysts either calcify or resolve completely, regardless of whether treated with albendazole. The stage of evolution of the cysticercus is an important consideration in the evaluation of albendazole effect on seizure outcome.
Neurocysticercosis in Latin America: Current epidemiological situation based on official statistics from four countries
(2022) Romo, Matthew L.
he present work shows the current trends in the frequency of neurocysticercosis hospitalizations in four endemic Latin American countries. Neurocysticercosis is a parasitic disease of the central nervous system that has been historically linked to poverty and poor sanitation. It is one of the neglected tropical diseases included in the PAHO/WHO action plan for their elimination. We compiled official data available from Brazil, Colombia, Ecuador, and Mexico. Our results show a clear and significant reduction in the disease burden in 3 of the 4 countries included. On the other hand, in Colombia, an increase in incidence was observed. These mixed results are of great relevance. They allow us to be optimistic about the possibility of eliminating this disease in some countries, but also allow us to consider why the disease does not seem to be controlled in other countries and direct public health measures aimed at eliminating this parasite in the countries that need it most.
Routine drug and food interactions during antihelminthic treatment of neurocysticercosis: a reason for the variable efficacy of albendazole and praziquantel?
(2014-04) Romo, Matthew L.; Carpio, Arturo; Kelvin, Elizabeth A.
Neurocysticercosis (NC) or infection of the central nervous system with Taenia solium larvae is a leading cause of preventable seizures and epilepsy in endemic regions across the globe. Albendazole and praziquantel are commonly used antihelminthic agents to treat NC; however, viable cysts persist in the majority of patients, putting them at risk for future seizures and other neurological complications. Because of their pharmacokinetic profiles, albendazole and praziquantel have the potential to interact with many different drugs. During antihelminthic treatment, antiepileptic drugs and corticosteroids are commonly co-administered to manage seizures and cerebral edema; however, the most commonly used agents from these drug classes are known to significantly alter plasma concentrations of albendazole and praziquantel. The overarching issue with drug interactions during the treatment of NC is whether or not they have clinical relevance, as the plasma concentrations of albendazole and praziquantel have not been directly linked with eradication of viable cysts. Future studies should attempt to evaluate the validity of a causal relationship between antihelminthic plasma concentrations and outcomes so that drug interactions can be better understood and managed and so that treatment can be optimized.
Should calcified neurocysticercosis lesions be surgically removed?
(2014-02) Carpio, Arturo; Romo, Matthew L.
Taenia solium seropositivity in patients with active epilepsy
(2014-11) Romo, Matthew L.; Carpio, Arturo
The relationship between neurocysticercosis and epilepsy: an endless debate
(2014) Carpio, Arturo; Romo, Matthew L.
Neurocysticercosis (NC), or cerebral infection with Taenia solium, is an important public health problem worldwide. Among the neurological sequelae of NC, seizures have been described as the most common symptom. Acute symptomatic seizures often result from degeneration of a viable cyst; however, not all of these patients with acute or provoked seizures will develop epilepsy (i.e., recurrent unprovoked seizures). Because of the high prevalence of epilepsy and NC, a causal, as well as incidental relationship between the two may exist. The epileptogenicity of calcified cysts as well as the potential association between NC and hippocampal sclerosis necessitates future research. Antihelminthic treatment of NC results in disappearance of viable cysts in about one-third of patients with parenchymal disease, but a reduction in seizure recurrence has not been demonstrated in randomized ontrolled trials. Prevention is critical to reduce the burden of seizure and epilepsy related to NC.Keywords: cysticercosis, Taenia solium, seizure, parasitic.