HEADACHE AND CYSTICERCOSIS IN ECUADOR, SOUTH-AMERICA

Intractable headaches have been described as the presenting complaint of many patients with T. solium neurocysticercosis. We conducted a hou se-to-house neuroepidemiological survey of 2,723 residents of an Andea n community, known to be endemic for this infection. Migraine headache s were confirmed in 187 cases (68.7 per thousand), and tension headach es were diagnosed in 77 cases (28.3 per thousand). Fifty-seven migrain e sufferers accepted computed tomography examination, and in 19 it rev ealed neurocysticercosis. In 11 out of 52 migraineurs who had their bl ood drawn, electron immunotransfer blot testing (EITB) was positive fo r anticysticercal antibodies. In a computer-generated random sample of this community, 109 headache free individuals were examined by CT, an d 87 had EITB. Of the 109 subjects examined by CT, 14 were positive fo r cysticercosis. Of the 87 individuals tested by EITB, 7 were positive . A statistically significant difference between the symptom-free gene ral population and the migraine patients was obtained for both CT (odd s ratio 3.39, P<0.005) and EITB (odds ratio 3.07, P<0.05) diagnosis of neurocysticercosis. Neurocysticercosis appears to be a significant ri sk factor for the presentation of migraine-type headaches in areas end emic for T. solium infection.