The Association between Neurocysticercosis and Epilepsy: Letter to the Editor

I read with interest the review “Unique Characteristics of Epilepsy Development in Neurocysticercosis,” published by Herrick et al.1 Neurocysticercosis (NCC) is a neglected zoonotic disease of high public health impact that is a cause of unacceptable morbidity and mortality.2 Epilepsy is one of the most common neurological disorders of the brain, and it is also
a public health imperative because it carries neurological, cognitive, psychological, and social consequences, and contributes substantially to the world’s burden of disease.3
Therefore, information regarding both these diseases should be based on reliable and rigorous scientific data. According to Herrick et al.,1 “NCC is the most common cause of adult-acquired epilepsy in the world.” This statement is not true. The authors based their statement on crosssectional studies, most of them addressed to determine the prevalence of epilepsy, and some with serious methodological flaws, such as establishment of the diagnosis of NC by serological tests (electroimmunotransfer blot). Diagnosis of NC must be based in neuroimaging, but serological tests may be used for confirmation.4 In studying the etiology of epilepsy, it is more appropriate to use incident cases rather than prevalent cases because one cannot distinguish among the potential etiological factors that preceded the onset of epilepsy, and, thus, cause and effect become difficult to establish with certainty. To our knowledge, there are no prospective cohort studies that have measured the risk of seizure recurrence (i.e., epilepsy) in patients with NC