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Epilepsy and neurocysticercosis in sub-Saharan Africa

Epilepsie und Neurozystizerkose in Subsaharan-Africa

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Zusammenfassung

Über die letzten Jahrzehnte hinweg konnten zahlreiche Studien belegen, dass Epilepsie in Subsahara-Afrika eine hochprävalente neurologische Erkrankung darstellt. Gründe hierfür sind mannigfaltig, Infektionen des zentralen Nervensystems spielen jedoch eine wichtige Rolle. Vor kurzem erst erkannte man Neurozystizerkose (NCC) als ernsthaftes Gesundheitsproblem mit steigender Tendenz in Subsahara-Afrika. Es wird geschätzt, dass NCC 30–50 % der erworbenen Epilepsien verursacht. NCC steht in unmittelbarem Zusammenhang mit der Schweinzystizerkose sowie der humanen Täniasis, erstere Erkrankung erreicht in einigen Schweinepopulationen Subsahara Afrikas fast 50%. In diesem Übersichtsartikel fassen wir zunächst die Prävalenz der Epilepsie in Subsahara-Afrika zusammen und zeigen einige Besonderheiten dieser Erkrankung im afrikanischen Kontext auf. Dann konzentrieren wir uns auf die Prävalenz der NCC, ihre klinischen Ausprägungen und gängige Diagnosekriterien für die NCC bezogen auf Afrika. Es schließt sich ein Abschnitt über die neuesten Entwicklungen in der serologischen Diagnostik der Zystizerkose und ein weiterer über therapeutische Aspekte an. NCC stellt einen häufigen Risikofaktor für Epilepsie dar; korrekte Diagnose und konsequente Behandlung der NCC könnte Epilepsie von Millionen von Menschen in Subsahara-Afrika heilen.

Summary

Over the last decades, studies in sub-Saharan Africa have indicated that epilepsy is a highly prevalent neurological disorder. Causes may be varied with infections of the central nervous system playing an important role. Neurocysticercosis (NCC) has recently been recognised as an emerging public health problem and a growing concern throughout sub-Saharan Africa and has been estimated to be responsible for 30–50% of acquired epilepsy. NCC is closely linked with porcine cysticercosis and human taeniosis, the former reaching a prevalence of almost 50% in some pig populations. In this review, we first summarize prevalence data on epilepsy and highlight some special aspects of the disorder within sub-Saharan Africa. We then focus on the prevalence of NCC, clinical signs and symptoms and diagnostic criteria for NCC with special reference to sub-Saharan Africa. This is followed by a section on the latest developments regarding serodiagnosis of cysticercosis and a section on care management of people infected with NCC. NCC clearly represents a major risk factor of epilepsy, thus detecting and treating NCC may help cure epilepsy in millions of people in sub-Saharan Africa.

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Authors and Affiliations

  1. Interdisciplinary Centre for Palliative Medicine and Department of Neurology, Ludwig-Maximilians-University, Munich, Germany

    Andrea Sylvia Winkler

  2. Haydom Lutheran Hospital, Manyara Region, Tanzania

    Andrea Sylvia Winkler

  3. WHO/FAO Collaborating Centre for Parasitic Zoonoses, Department of Parasitology, Health and Development, Faculty of Life Sciences, University of Copenhagen, Copenhagen, Denmark

    Arve Lee Willingham 3rd

  4. Department of Paraclinical Studies, School of Veterinary Medicine, University of Zambia, Lusaka, Zambia

    Chummy Sikalizyo Sikasunge

  5. Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria

    Erich Schmutzhard

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  1. Andrea Sylvia Winkler
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Correspondence to Andrea Sylvia Winkler.

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Winkler, A., Willingham, A., Sikasunge, C. et al. Epilepsy and neurocysticercosis in sub-Saharan Africa. Wien Klin Wochenschr 121 (Suppl 3), 3–12 (2009). https://doi.org/10.1007/s00508-009-1242-3

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