Neurocysticercosis: a commonest neuroimaging abnormalitiy in children with first afebrile seizure in central India

Abstract

Background: Seizures are the commonest neurological ailments in paediatrics in ~10%, even though the role of emergent neuroimaging in first onset afebrile seizure is not well defined.Methods: A prospective observational study was conducted in NSCB Medical College, Jabalpur, Madhya Pradesh, India to determine the incidence of neuroimaging abnormalities in children with first onset afebrile seizure and to make specific recommendations for use of routine neuroimaging in the new onset afebrile seizure. A total of 75 children (1 month to 14 years of age) with the new-onset afebrile seizure were enrolled and underwent clinical examination & neuroimaging. We defined first seizure using the international league against epilepsy (ILAE). The data were recorded and analysed by Student ‘t’ test for continuous variables, Fisher’s Exact Test or Chi square test for categorical variables. The critical level of significance was considered at P < 0.05 level.Results: Neuroimaging abnormalities were found in 66.7% of the cases, mostly in the children above 2 years of age (72.6 %) (P value <0.05). A significant relationship (P <0.001) was observed between focality (partial seizures (83.8%)) and abnormal neuroimaging, among these neurocysticercosis (26.7%) were in highest proportion with parietal lobe as the commonest involvement. The cases with contact history of tuberculosis /mantoux positivity/abnormal chest radiography were found significantly interrelated with tuberculoma (P <0.05).Conclusions: In developing countries like India the prevalence of neurocysticercosis and tuberculoma is high, hence neuroimaging in all cases of first onset afebrile seizure/ focal seizure with mantoux positive/ history of Contact /abnormal chest radiograph can be kept in a view for better management of child.