Are seizures associated with neuroschistosomiasis mansoni? An exploratory survey in an endemic area of Brazil

Trans R Soc Trop Med Hyg. 2022 Aug 5;116(8):704-709. doi: 10.1093/trstmh/trac012.

Abstract

Background: Deposition of Schistosoma mansoni eggs in the brain of patients with hepatosplenic schistosomiasis (HS-SM) is frequent and usually asymptomatic. However, it is questioned whether it could cause seizures. Thus, we investigated the occurrence of seizures in these patients and also searched for parameters associated with this disorder.

Methods: In a cross-sectional survey, we compared 128 patients with HS-SM with 102 patients with portal hypertension due to compensated chronic hepatic disease of other etiologies. A standardized questionnaire, emphasizing epilepsy-related parameters, was applied to all participants.

Results: Eight (6.3%) patients with HS-SM had a history of seizures, whereas this condition was reported by three (2.9%) individuals from the comparison group (p=0.354). None of the variables were associated with the occurrence of seizures, either in univariate or in multivariate analysis.

Conclusions: The frequency of seizures was similar in both study groups. However, it was higher than that described in population-based studies. Thus, we hypothesize that HS-SM individuals may have a higher frequency of seizure. The lack of difference between the two study groups may be explained by the inclusion of cases of HS-MS overlapping other chronic liver diseases in the comparison group, because this finding is relatively common in schistosome-endemic areas.

Keywords: Schistosoma mansoni; epilepsy; neuroschistosomiasis; schistosomiasis; seizure; survey.

MeSH terms

  • Animals
  • Brazil / epidemiology
  • Cross-Sectional Studies
  • Humans
  • Liver Diseases*
  • Neuroschistosomiasis* / complications
  • Schistosoma mansoni
  • Schistosomiasis mansoni* / complications
  • Schistosomiasis mansoni* / epidemiology
  • Schistosomiasis* / complications
  • Seizures / epidemiology
  • Seizures / etiology
  • Surveys and Questionnaires