Cerebral Cysticercosis

Abstract

In this country, cerebral cysticercosis is not commonly implicated as the etiology of an otherwise uncomplicated seizure disorder occurring during childhood. Nine children with neurologic symptomatology and radiographic (computed tomography) evidence consistent with cerebral cysticercosis have been evaluated. Each patient was born and resided for some period (1½ to 10 years) in an endemic area. Principal symptomatology consisted of a generalized seizure disorder. EEGs were normal in five patients and nonspecific in two. Serologic studies on serum and CSF were negative in 8/9 patients including the single patient requiring surgical intervention for excision of a cysticercal cyst. Cerebral nuclide scanning was not helpful and skull radiography was used to diagnose intracerebral calcifications in six patients. Computed tomography revealed multiple calcifications in six patients and a solitary lesion in one. Five patients had enhancing cystic lesions including three of those with diffuse calcifications. Since the natural history of cerebral cysticercosis presenting in this fashion is benign, symptomatic treatment is often sufficient. Anticonvulsants generally provide adequate seizure control. In one patient, cyst removal was necessary to achieve seizure control. On the basis of this experience, conclusions are (1) that the incidence of cerebral cysticercosis in exposed children is higher than commonly appreciated, and (2) that computed tomography may assist in the establishment of the diagnosis.