Singh G, Ram S, Kaushal V, Kumar S, Bhatia R C, Raizada N, Kaushal R K
Department of Medicine, Dayanand Medical College, 141001, Punjab, Ludhiana, India.
J Neurol Sci. 2000 Jun 15;176(2):131-5. doi: 10.1016/s0022-510x(00)00341-5.
A small, single enhancing lesion (SEL) is often noted upon computed tomography (CT) in children and young adults with recent focal or generalized seizures. A high frequency of seizures has been reported in family members of persons with SEL. We studied the prevalence of seizures and cysticercus electro-immuno-transfer blot (EITB) based seropositivity among family members, specifically household family contacts of pediatric subjects with a SEL. An attempt was also made to determine the etiology of seizures in household family contacts using magnetic resonance imaging (MRI). Information regarding seizure semiology, personal and food habits and detailed family pedigrees was obtained from 20 consecutive pediatric subjects with a SEL and 51 of their household family contacts. EITB sero-assays and stool examinations were performed on all participating subjects. MRIs were done on all EITB positive household family contacts. A family history of seizures was obtained in six index children (30%) (five household first-degree relatives and two distant relatives). Seventeen index children (85%) and 14 family contacts (27%) were EITB positive. A tendency towards clustering of EITB positive cases within individual families was observed. Stool examinations did not reveal Taenia species ova in any of EITB positive subjects. Neuroimaging studies revealed abnormalities consistent with active or inactive neurocysticercosis in all five household family contacts with history of seizures. Four of these five subjects were EITB positive and one was EITB negative. We concluded that children with SEL and seizures may have a family history of seizures. There is a high seropositivity rate in household family contacts of pediatric subjects with solitary cysticercus granulomas (SCGs). EITB based seropositivity in household family contacts with seizures, strongly predicts a cysticercal etiology for seizures. It may be worthwhile to screen household family contacts of children with SEL for taeniasis-cysticercosis.
在近期发生局灶性或全身性癫痫发作的儿童和年轻人中，计算机断层扫描（CT）检查时常常会发现一个小的、单一的强化病灶（SEL）。据报道，患有SEL的人的家庭成员癫痫发作频率较高。我们研究了家庭成员，特别是患有SEL的儿科患者的家庭内部接触者中癫痫发作的患病率以及基于囊尾蚴电免疫转移印迹法（EITB）的血清学阳性率。我们还尝试使用磁共振成像（MRI）来确定家庭内部接触者癫痫发作的病因。从连续20例患有SEL的儿科患者及其51名家庭内部接触者那里获取了有关癫痫发作症状学、个人和饮食习惯以及详细家族谱系的信息。对所有参与研究的对象进行了EITB血清学检测和粪便检查。对所有EITB阳性的家庭内部接触者进行了MRI检查。在6名索引儿童（30%）（5名家庭一级亲属和2名远亲）中发现有癫痫家族史。17名索引儿童（85%）和14名家庭接触者（27%）EITB呈阳性。观察到EITB阳性病例在各个家庭中有聚集倾向。粪便检查在任何EITB阳性对象中均未发现带绦虫卵。神经影像学研究显示，所有5名有癫痫发作史的家庭内部接触者均有与活动性或非活动性神经囊尾蚴病相符的异常表现。这5名对象中有4名EITB呈阳性，1名EITB呈阴性。我们得出结论，患有SEL和癫痫发作的儿童可能有癫痫家族史。患有孤立性囊尾蚴肉芽肿（SCG）的儿科患者的家庭内部接触者血清学阳性率很高。有癫痫发作的家庭内部接触者中基于EITB的血清学阳性强烈预示癫痫发作的囊尾蚴病因。对患有SEL的儿童的家庭内部接触者进行绦虫病 - 囊尾蚴病筛查可能是值得的。
