Neurocisticercose
Atualização sobre uma antiga doença
DOI:
https://doi.org/10.34024/rnc.2010.v18.8444Palavras-chave:
Neurocisticercose, Diagnóstico, PrognósticoResumo
Introdução. A neurocisticercose (NCC) é a infecção parasitária mais comum do sistema nervoso central (SNC). Estima-se que cerca de 50 milhões de pessoas são infectadas nos países em desenvolvimento, sendo considerada endêmica principalmente na América Latina, na América Central, na Ásia e na África. Este artigo se propõe revisar os conhecimentos mais atuais da neurocisticercose, com enfoque para os principais achados clínicos e anatomopatológicos apresentados pelos pacientes, estudos em modelos animais, testes diagnósticos e a terapêutica medicamentosa implementada. Método. Trata-se de um estudo de atualização de literatura, quando foram realizadas buscas nas bases de dados MedLine, Scielo, Lilacs e Pubmed, nos idiomas inglês e português. A maioria dos artigos relacionados foi publicada no período compreendido entre os anos de 2000 e 2008. Resultados. Muitos indivíduos com neurocisticercose são assintomáticos. Nos indivíduos sintomáticos, os achados clínicos são dependentes da localização, do tamanho e da quantidade de cistos, além do processo auto-imune relacionado à agressão do parasita ao SNC. Conclusão. O tratamento da neurocisticercose pode ser clínico ou cirúrgico e o prognóstico variável.
Referências
Pedretti L, Bedaque EA, Sotelo J, Del Brutto OH. Cisticercose. In: Veronesi R, Focaccia R (eds) Tratado de Infectologia, Atheneu, São Paulo 1999, p.1332-47.
Neves DP. Parasitologia Dinâmica. São Paulo: Editora Atheneu 2003, 474p.
Casanova C, Puccioni-Sohler M, Peralta JM. Infecções Parasitárias: Neurocisticercose. In: Marzia Puccioni - Sohler. (Org.). Diagnóstico de Neuroinfecção com abordagem dos exames do Líquido Cefalorraquidiano e Neuroimagem. Rio de Janeiro: Rubio 2008, p.77-83.
Lino-Júnior RS, Ribeiro PM, Antonelli EJ, Faleiros ACG, Terra SA, Reis MA, Teixeira VPA. Características evolutivas do Cysticercus cellulosae no encéfalo e no coração humanos. Rev Soc Bras Med Trop 2002;35:617-22. DOI: https://doi.org/10.1590/S0037-86822002000600012
Sotelo J, Del Brutto, OH. Review of neurocysticercosis. Neurosurg Focus 2002;12:1-6. DOI: https://doi.org/10.3171/foc.2002.12.6.2
Rey L. Parasitologia. Rio de Janeiro: Editora Guanabara Koogan 1991, 731p.
Elias FM, Martins MT, Foronda R, Jorge WA, Araújo NS. Oral Cysticercosis: Case report and review of the literature. Rev Inst Med Trop S. Paulo 2005;47:95-8.
Del Brutto OH, Sotelo J. Neurocysticercosis: an update. Reviews of Infectious Diseases 1988;10:1075-87. DOI: https://doi.org/10.1093/clinids/10.6.1075
Garcia HH, Del Brutto OH, Nash TE, White Jr AC, Tsang VCW, Gilman RH. New concepts in tha dignosis and managemente of neurocysticercosis (Taenia solium). Am J Trop Med Hyg 2005;72:3-9. DOI: https://doi.org/10.4269/ajtmh.2005.72.3
Lino-Junior RS, Faleiros ACG, Vinaud MC, Oliveira FA, Guimarães JV, Reis MA, et al. Anatomopathological aspects of Neurocysticercosis in autopsied patients. Arq Neuropsiquiatr 2007;65:87-91. DOI: https://doi.org/10.1590/S0004-282X2007000100019
Benedeti MR, Falavigna, DLM, Falavigna-Guilherme AL, Araújo SM. Perfil clínico-epidemiológico de pacientes com NCC atendidos no Hospital Universitário Regional de Maringá, Paraná, Brasil. Arq Neuropsiquiatr 2007;65: 124-9. DOI: https://doi.org/10.1590/S0004-282X2007000100025
Agapejev S, Yela DA, Gomes AE. Edema cerebral crônico na neurocisticercose. Arq Neuropsiquiatr 1998;56: 569-76. DOI: https://doi.org/10.1590/S0004-282X1998000400009
Agapejev S, Pouza FP, Bazan R, Faleiros ATS. Aspectos clínicos e evolutivos da hidrocefalia na neurocisticercose. Arq Neuropsiquiatr 2007;65:674-80. DOI: https://doi.org/10.1590/S0004-282X2007000400025
Leal Filho MB, De Castro JAF, Silva Vieira MAC, Xavier AA, Almeida BR, Morais RK P, et al. Relato de caso. Forma tumoral de neurocisticercose. Arq Neuropsiquiatr 2002;60:844-6. DOI: https://doi.org/10.1590/S0004-282X2002000500029
Rocha MSG, Brucki SMD, Ferraz AC. Doença cerebrovascular e neurocisticercose. Arq Neuropsiquitr 2001;59: 778-83. DOI: https://doi.org/10.1590/S0004-282X2001000500023
Agapejev, SS, Resende MD, Lima LA. Polyradiculoneuretis and neurocysticercosis: a case report. Arq Neuropsiquiatr 1996;54:107-13 DOI: https://doi.org/10.1590/S0004-282X1996000100018
Rolemberg FLD, Fagundes-Pereyra WJ, Souza CT, Souza AA. Cisticercose intramedular: relato de caso/Intramedular cysticercosis: case report. Arq Neuropsiquiatr 1999;57:301-5. DOI: https://doi.org/10.1590/S0004-282X1999000200023
Mendes EC, Scintilla SS, Fonseca EA, Souza HR, Carvalho RW. A neurocisticercose humana na Baixada Fluminense. Arq Neuropsiquiatr 2005;63:1058-62. DOI: https://doi.org/10.1590/S0004-282X2005000600027
Agapejev S. Aspectos clínico-epidemiológicos da neurocisticercose no Brasil: análise crítica. Arq Neuropsiquiatr 2003;60:211-8. DOI: https://doi.org/10.1590/S0004-282X2002000200005
Chavarría A, Roger B, Fragoso G, Tapia G, Fleury A, Dumas M, et al. TH2 profile in asymptomatic Taenia solium human neurocysticercosis. Microbes Infection 2003;5:1109-15. DOI: https://doi.org/10.1016/S1286-4579(03)00206-5
Chavarria A, Fleury A, Bobes RJ, Morales J, Fragoso JG, Sciutto E. A depressed peripheral cellular immune response is related to symptomatic neurocysticercosis. Microbes Infection 2005;8:1082-9. DOI: https://doi.org/10.1016/j.micinf.2005.11.005
Chavarría A, Fleury A, Márquez EGC, Fragoso G, Sciutto E. Relationship between the clinical heterogeneity of neurocysticercosis and the immune-inflammatory profiles. Clinical Immunology 2005;116:271-8. DOI: https://doi.org/10.1016/j.clim.2005.04.008
Thussu A, Sehgal S, Sharma M, Lal V, Sawhney IMS, Prabhakar S. Comparison of cellular responses in single- and multiple-lesion neurocysticercosis. Ann Trop Med Parasitol 1997;91:627-32. DOI: https://doi.org/10.1080/00034983.1997.11813181
Bueno, EC, Machado LR, Livramento JA, Vaz AJ. Cellular immune response of patients with neurocysticercosis (inflammatory and non-inflammatory phases). Acta Tropica 2004;9:205-13. DOI: https://doi.org/10.1016/j.actatropica.2004.05.010
Del Brutto OH, Rajshekhar V, White Jr AC, Tsang VC, Nash TE, Takayanagui OM, et al. Proposed diagnostic criteria for neurocysticercosis. Neurology 2001;57:177-83. DOI: https://doi.org/10.1212/WNL.57.2.177
Almeida CR, Ojopi EP, Nunes CM, Machado LR, Takayanagui OM, Livramento JA, et al. Taenia solium DNA is present in the cerebrospinal fluid of neurocysticercosis patients and can be used for diagnosis. European Arch Psychiatr Clin Neurosc 2006;256:307-10. DOI: https://doi.org/10.1007/s00406-006-0612-3
Bueno EC, Adelaide JV, Machado LR, Livramento JA. Neurocysticercosis. Detection of IgG, IgA and IgE antibodies in cerebrospinal fluid, serum and saliva samples by ELISA with Taenia solium and Tania crassiceps antigens. Arq Neuropsiquiatr 2000;58:18-24. DOI: https://doi.org/10.1590/S0004-282X2000000100003
Garcia HH, Del Brutto OH. Imaging findings in neurocysticercosis. Acta Trop 2003;87:71-8. DOI: https://doi.org/10.1016/S0001-706X(03)00057-3
Del Brutto OH. Cysticercosis and cerebrovascular disease: a review. J Neurol Neurosurg Psychiatry 1992;55: 252-4. DOI: https://doi.org/10.1136/jnnp.55.4.252
Goedert, AV; Silva SHF. Cisticercose espinhal/ Spinal cysticercosis. Rev Imagem 1990;1/2:39-48.
García HH, Pretell EJ, Gilman RH, Martínez SM, Moulton LH, Del Brutto OH, et al. A trial of antiparasitic treatment to reduce the rate of seizures due to cerebral cysticercosis. N Engl J Med 2004;350:249-58. DOI: https://doi.org/10.1056/NEJMoa031294
Gilman RH, Del Brutto OH, García HH, Martínez M. Prevalence of taeniosis among patients with neurocysticercosis is related to severity of infection. The Cysticercosis Working Group in Peru. Neurology 2000, 55:1062. DOI: https://doi.org/10.1212/WNL.55.7.1062
Pérez-López C, Isla-Guerrero A, Alvarez F, Budke M, Fernández-Miranda J, Paz J, et al. Actualización en el tratamiento de la neurocisticercosis. Rev Neurol 2003;36:805-11. DOI: https://doi.org/10.33588/rn.3609.2003033
Nogales-Gaete J, Arriagada RC, Salinas RR. Tratamiento de la neurocisticercosis: Revisión critica. Rev méd Chile 2006;134:789-96. DOI: https://doi.org/10.4067/S0034-98872006000600017
Rajshekhar V. Purging the worm: management of Taenia solium taeniasis. Lancet 2004;363:912. DOI: https://doi.org/10.1016/S0140-6736(04)15820-0
García HH, Evans CA, Nash TE, Takayanagui OM, White AC Jr, Botero D, et al. Current consensus guidelines for treatment of neurocysticercosis. Clin Microbiol Rev 2002;15:747-56. DOI: https://doi.org/10.1128/CMR.15.4.747-756.2002
Carpio A. Neurocysticercosis: an update. Lancet Infect Dis 2002;2:751-62. DOI: https://doi.org/10.1016/S1473-3099(02)00454-1
Citow J, Johnson P, Mc Bride D, Ammirati M. Imaging features and surgery-related outcomes in intraventricular neurocysticercosis. Neurosurg Focus (e-journal) 2002;12:e6. DOI: https://doi.org/10.3171/foc.2002.12.6.7
Cuetter A, Andrews R. Intraventricular neurocysticercosis: 18 consecutive patients and review of the literature. Neurosurg Focus (e-journal) 2002;12:e5. DOI: https://doi.org/10.3171/foc.2002.12.6.6
Kelley R, Duong D, Locke G. Characteristics of Ventricular Shunt Malfunctions among patients with Neurocysticercosis. Neurosurgery 2002;50:757-62. DOI: https://doi.org/10.1097/00006123-200204000-00014
Cruz-Ultreras I, Cruz M. Tratamiento médico de la neurocisticercosis. En: Arriagada C, Nogales-Gaete J, Apt W, eds. Neurocisticercosis. Santiago: ARRYNOG 1997, p.287-98.
Barinagarrementería F, Cantú C. Arteritis cerebral cisticercosa. En: Arriagada C, Nogales-Gaete J, Apt W, eds. Neurocisticercosis. Santiago: ARRYNOG 1997, p.139-52.
Cantú C, Barinagarrementería F. Cerebrovascular complications of neurocysticercosis: Clinical and neuroimaging spectrum. Arch Neurol 1966;53: 233-9. DOI: https://doi.org/10.1001/archneur.1996.00550030039021
Ferreira LS, Zanardi VA, Li ML, Guerreiro MM. Interrelationship between radiologic findings and prognosis of epilepsy in children with neurocysticercosis. Arq Neuropsiquiatr 2002;60:1-5. DOI: https://doi.org/10.1590/S0004-282X2002000100001
Colli BO, Carlotti CG, Assirati JA, Machado HR, Valenca M, Amato MC. Surgical treatment of cerebral cysticercosis: long-term results and prognostic factors. Neurosurg Focus 2002;12:e. DOI: https://doi.org/10.3171/foc.2002.12.6.4
Ito A, Nakaya K, Sako Y, Nakao M, Ito M. NOD-scid mouse as an experimental animal model for cysticercosis. Southeast Asian J Trop Med Public Health 2001;32 (Suppl 2):85-9.
Stringer JL, Marks LM, White AC, Robinson P. Epileptogenic activity of granulomas associated with murine cysticercosis. Exp Neurol 2003;183:532-6. DOI: https://doi.org/10.1016/S0014-4886(03)00179-1
Cardona AE, Restrepo BI, Jaramillo JM, Teale JM. Development of an animal model for neurocysticercosis: immune response in the central nervous system is characterized by a predominance of gamma delta T cells. J Immunol 1999;162:995-1002.
Fan PC, Chung WC, Wu JC. Experimental infection of an isolate of Taenia solium from Hainan in domestic animals. J Helminthol 1994;68:265-6. DOI: https://doi.org/10.1017/S0022149X00014450
Ito A, Putra MI, Subahar R, Sato MO, Okamoto M, Sako Y, et al. Dogs as alternative intermediate hosts of Taenia solium in Papua (Irian Jaya), Indonesia confirmed by highly specific ELISA and immunoblot using native and recombinant antigens and mitochondrial DNA analysis. J Helminthol 2002;76:311-4. DOI: https://doi.org/10.1079/JOH2002128
Baig S, Damian RT, Morales-Montor J, Ghaleb A, Baghdadi A, White AC. Protection from murine cysticercosis by immunization with a parasite cysteine protease. Microbes Infect 2006;8:2733-5. DOI: https://doi.org/10.1016/j.micinf.2006.08.002
