A longitudinal study of neurocysticercosis through CT scan of the brain

Abstract

Objective To find out the role of CT scan in the diagnosis of neurocysticercosis (NC) and also to get an idea of the nature and extent of this disease in a definite geographical ethnic location. Methods CT scan of the brain of altogether 4 762 persons residing in a congested area of central Kolkata, was performed between 2004 and 2010, in an imaging centre in central Kolkata (Calcutta), of whom 1 114 (23.39%) suspected patients were investigated for NC, having complaints of convulsion (472), headache (272), right sided weakness (98), loss of consciousness (84), left sided weakness (61), abnormal behavior (48), slurring of speech (34), difficulty with keeping balance (33) and dementia (12). Results NC was detected in 45, 1, 0, 2, 1, 0, 0, 1 and 0, respectively consisting 4.48% (50/1 114) of the suspected cases varying from as low as 2 (in 2006) to as high as 23 (in 2005) in different years indicating this parasitic infection is perennial. The age of patients varied from 6 to 59 years of whom 28 (56%) were vegan. We were also able to detect 4 types of lesions viz. calcified lesions (14), small hypodense i.e. vesicle (12), bright central spot i.e. vesicular lesion with central spot (2) and ring enhancement (22). For 3 patients, further imaging investigation (MRI) was needed to confirm the diagnosis. We calculated the specificity and sensitivity of CT scan of brain diagnosing NC which was found to be 64% and 100%, respectively. Conclusions Although, the sample may not be the representatives of the whole community, the findings suggest that cysticercosis is a significant but under-recognized public health concern in Kolkata.