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This chapter reviews some of the parasitic disorders including sparganosis, toxocariasis, onchocerciasis, schistosomiasis and paragonimiasis, which may involve the central nervous system (CNS) and for which an association with seizures and epilepsy has been described. It is important that neurologists across the globe are aware of the epidemiology, clinical manifestations, and treatment of the parasitic disorders. Although the association between epilepsy and parasitic diseases has been generally recognized, most research and literature concerning the association is related to infection with Taenia solium cysticercosis. When brain lesions are demonstrated on imaging studies of individuals presenting with seizures, histological examination of these lesions through biopsy provides proof of the causal association between the parasitic disorder and seizures. The effects of anthelminthic drugs and the role of antiepileptic drugs on the seizure outcome also need to be considered. The aim is to eradicate these disorders through scientifically established and properly legislated preventive measures.
This chapter talks about Hashimoto encephalopathy and the treatment-responsive encephalopathies associated with antibodies to neuronal antigens. Epilepsy has also been associated with the inflammatory bowel diseases (ulcerative colitis, Crohn disease, and celiac disease), although this association is more contentious. The chapter discusses the clinical features and treatment options for limbic encephalitis (LE) and the association of LE with epilepsy. Hu/ANNA-1, Ma-2, collapsin-response-mediator protein, amphiphysin and glutamic acid decarboxylase are intracellular antigens associated with LE. Voltage-gated potassium channels, N-methyl-D-aspartate receptor are extracellular antigens associated with LE. Accepted medical treatments for surface-antigen-related LE are high-dose steroids, plasma exchange, and/or intravenous immunoglobulin (IVIG), which are sometimes given in combination. The index disease for autoimmune thyroiditis group of immune-mediated epilepsy syndromes is the entity known as Hashimoto encephalopathy or steroid-responsive encephalopathy associated with autoimmune thyroiditis (SREAT). The chapter also discusses the management of inflammatory bowel disease (IBD) and SREAT.
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