Clinical profile and outcome of pediatric neurocysticercosis: A study from Western Nepal

Abstract

Neurocysticercosis (NCC) is a very common pediatric neurological problem in Western Nepal. Its magnitude is not adequately known as in most situations it remains as an iceberg. To define the problem a retrospective study of the clinical profile, response to treatment and follow-up of the pediatric cases was done. Hospital records of inpatients admitted in the last 4 years (2000-2003) with the diagnosis of NCC were reviewed. Diagnosis was primarily based on clinical features, computed tomography (CT) scan features and exclusion of other causes. All patients were treated with 28 days' course of albendazole, anti-edema drugs and anticonvulsants. Follow-up period varied from 1 to 3 years. The medical records of 124 children with NCC were evaluated. The most common age group affected was 10-12 years with the youngest patient of 11 months. Partial seizure was the most prominent presentation. The most frequent finding in CT scan was single ring-enhancing lesion with perilesional edema affecting the parietal lobe. Twenty patients were lost to follow up. Ninety-eight patients had complete clinical response and 87 of them had complete disappearance of lesion in CT scan at the end of 1 year. Recurrence of seizure was the only residual symptom found in six (4.8%) patients, all of them having calcified lesions in CT scan. In areas where NCC is endemic, partial seizure in the pediatric age group is highly suggestive and should be considered as a potential indicator of the disease. Considering the lower cost and easy availability, CT scan remains the best investigation for confirmation of diagnosis in a developing country like Nepal. The disease is usually completely curable. Recurrent partial seizure is the only residual symptom, which may occur more commonly in patients with calcified lesions.