Prevalence, Response to Cysticidal Therapy, and Risk Factors for Persistent Seizure in Indian Children with Neurocysticercosis

Abstract

Background. Neurocysticercosis (NCC) is the commonest cause of childhood acquired epilepsy in developing countries. The use of cysticidal therapy in NCC, except “single lesion NCC,” is still debated in view of its doubtful usefulness and potential adverse effects. Methods. Children presenting with first episode of seizure or acute focal neurological deficit without fever were screened for NCC and received appropriate therapy (followup done for 1 year to look for the response and side effects). Results. The prevalence of NCC was 4.5%. Most common presenting feature was generalized seizure and commonest imaging finding was single small enhancing lesion in the parietal lobe. Abnormal EEG and CSF abnormalities were found in almost half of the children. The response to therapy was very good with infrequent recurrence of seizure and adverse effects of therapy were encountered rarely. No risk factors for persistent seizure could be identified. Conclusion. Present study shows that the response to cysticidal therapy is very good in NCC as seizure recurrence was observed in only 5%, 4.2%, and 4.2% of cases at 3-month, 6-month, and 1-year followup. Adverse effects of therapy were observed in 20% of cases during therapy but they were mild and self-limiting.

Occurrence of neurocysticercosis in patients presenting with seizure and its serological evaluation

“…9 Kumar et al, also reported a dominance of males (55.8%). 18 These findings in general suggest that gender related differences in different studies are incidental and does not indicate any gender associated risk of seizures.…”

“…This finding is similar to the observation of Kumar et al, who in a study of 120 cases of NCC reported a dominance of non-vegetarians (64.2%), however, Pandit et al, in their study of 50 cases of NCC had only 32% nonvegetarians. 18,20 These findings suggest that nonvegetarian diet necessarily need not be the source of transmission of NCC.…”

“…11 Kumar et al, on the other hand found positivity rate of 71% which is much higher than that observed in present study. 18 Variability in NCC rate in different studies might be dependent on the sampling frame, endemicity and profile of the study population being studied.…”

“…Pathologically, it is difficult to be performed and serological tests often have low sensitivity despite being reported for high specificity. 17,18 Neuroimaging is the preferred modality for neurocysticercosis diagnosis. Computed tomography (CT), Magnetic resonance imaging (MRI) and Proton Magnetic Resonance Spectroscopy (MRS) are some of the neuroimaging modalities commonly used for diagnosis.…”

Screening for neurocysticercosis in internationally adopted children: yield, cost and performance of serological tests, Italy, 2001 to 2016

“…However, NCC is responsible for a non-negligible portion of epilepsy cases in children as well. In Northern India, the reported NCC prevalence was 4.5% among children aged 1 to 14 years presenting to a tertiary care hospital with a first episode of seizure or acute focal neurological deficit [ 12 ]. According to another community-based study conducted in the city of Kolkata, India, the prevalence of NCC among patients aged 19 years or less with active epilepsy was 23.4% [ 13 ].…”