Abstract
Neurocysticercosis (NCC) is an acquired parasitic infection of the central nervous system (CNS) in humans caused by encysted pork tapeworm larvae, namely Taenia solium. NCC has been discovered to be the most common etiology of focal seizure among the pediatric population. The severe CNS sequelae by NCC might cause to poor quality of life, eventually lead to sudden death. In this study, we report a case of NCC in a fifteen-year-old girl. Case illustration: a fifteen-year-old girl suddenly experienced a focal seizure of the right hand, along with a decreased of consciousness. The duration of the seizure was less than five minutes. It recurred for three times since ten hours before admission to hospital. She admitted that it was the first unprovoked seizure in her life. There was no record of fever and cough. She had a history of eating pork in the rural region of Sumba Island. Physical examination demonstrated GCS E3V4M5, normal findings of general and neurological status. Computed Tomography (CT) scan with contrast revealed a hypodense calcified lesion appended by a cyst with a dot sign, located at the grey-white matter junction at left parietal region. These findings supported colloidal vesicular stage of NCC. The diagnosis of this patient was neurocysticercosis. Therefore, she was given albendazole 400mg bid and valproic acid (15mg/kg/day) for a month, and intravenous dexamethasone (1mg/kg) with a maximum dose of 12 mg qid. After a month of treatment, she did not either have any seizure or other complaints. CT scan evaluation demonstrated a radiological improvement. Summary: NCC is identified as one of the commonest causes of epilepsy and seizure. The combination between antiparasitic with another supportive therapy gives comprehensive treatment of NCC.
Highlights
Neurocysticercosis is an acquired parasitic infection of the central nervous system (CNS) in humans caused by encysted larvae of Taenia solium
It is a great challenge for the clinician for diagnosing NCC, as it does not have any classic clinical manifestation. [4, 11,12,13] Neuroimaging, such as Computed Tomography (CT) and Magnetic Resonance Imaging (MRI), has been known to be a fundamental investigations in order to make the diagnosis of NCC. [5, 14]
Studies have declared that seizure as the most frequent clinical manifestation of NCC. [3, 5, 10, 16] In addition, there were researches which discovered that focal seizure without generalization as the most common type of the seizure which caused by NCC. [17, 21] some researches have proven that NCC as the etiology of late-onset epilepsy among pediatrics population, [18, 19] especially at the endemic regions which has been known that the parasitic infection was still high, like Southeast Asia. [3, 21]
Summary
Neurocysticercosis is an acquired parasitic infection of the central nervous system (CNS) in humans caused by encysted larvae of Taenia solium. This study presents a case report of NCC in girl age 15 years old with highlight of diagnosing and treating problems which discovered in this patient. History of growth and development fit to age Her immunization report was complete according to the national health ministry standard. Albendazole, as the anti-parasitic drug, with a dosage 400 mg/ 12 hours was given to this patient orally for a month. Albendazole 400 mg/24 hours orally was given for one more week and valproic acid 15 mg/kg/day was given for two years as the anti-epileptic drug for this patient. The CT scan evaluation will be administered to the patient after one year of therapy The patient and her family were educated to prepare any type of meat properly until it is perfectly cooked in order to avoid the parasitic infection, especially cysticercosis, and the parents were
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