Neurocysticercosis (NCC) in Children: A Review

Abstract

Neurocysticercosis (NCC) is the commonest parasitic infestation of the brain caused by Taenia solium larvae and a preventable cause of epilepsy worldwide. NCC may be parenchymal or extraparenchymal, and its clinical presentation may vary based on the location, number, and host immuneresponse to the cysts. Seizures are more frequently seen in children, and single colloidal parenchymal cyst is the common radiologic finding in pediatric NCC. The diagnosis is generally by neuroimaging, a scolex within the cyst being pathognomic; however, serology may help when the neuroimaging is inconclusive. Initial treatment generally focuses on symptomatic management by antiepileptics and corticosteroids. Albendazole is the cysticidal drug of choice in most cases; praziquental is added for multiple lesions. The outcome depends on the type, location, number of lesions, seizure recurrences and radiologic resolution of the lesions. Single lesions have a better prognosis. In endemic areas, NCC should be a differential in any child presenting with recentonset seizures, headache, vomiting, or focal motor deficits, in the absence of another known neurological condition. Due to the potentially eradicable nature of cysticercosis, preventive measures need to be encouraged.