Del Brutto OH, et al. – The researchers evaluated prevalence and patterns of presentation of neurocysticercosis (NCC) and its relationship with epilepsy in community–dwellers aged ≥20 years living in Atahualpa (rural Ecuador) using a large–scale population–based study. They revealed that compared to those without epilepsy, persons with epilepsy (PWE) had 3 times the odds of having NCC, producing strong epidemiological evidence supporting the relationship between NCC and epilepsy.

• The researchers identified individuals with suspected seizures during a door-to-door survey and an interview (phase I) in a three-phase epidemiological study.
• Next, neurologists assessed suspected cases and randomly selected negative persons to estimate epilepsy prevalence (phase II).
• All participants were offered noncontrast computed tomography (CT) for identifying NCC cases in phase III.
• They evaluated the independent association between NCC (exposure) and epilepsy (outcome) by the use of multivariate logistic regression models adjusted for age, sex, level of education, and alcohol intake.
• To archived brain magnetic resonance imaging in a sizable subgroup of participants, CT findings were subsequently compared.

• The researchers enrolled 1,462 villagers (91%) among 1,604 villagers aged ≥20 years.
• They identified 41 persons with epilepsy (PWE), for a crude prevalence of epilepsy of 28 per 1,000 population (95% confidence interval [CI] = 20.7–38.2).
• They performed a head CT in 1,228 (84%) of 1,462 participants, including 39 of 41 PWE.
• CT demonstrated lesions consistent with calcified parenchymal brain cysticerci in 118 (9.6%) cases (95% CI = 8.1–11.4%).
• No patient had other forms of NCC.
• 9 of 39 PWE had NCC as opposed to 109 of 1,189 participants without epilepsy (23.1% vs. 9.2%, p = 0.004).
• In the adjusted logistic regression model, this difference persisted (odds ratio = 3.04, 95% CI = 1.35–6.81, p = 0.007).