Bhattacharjee Shakya, Biswas Prativa, Mondal Tanushree
Department of Neurology, Mater Misericordaie University Hospital, Dublin - 7, Ireland.
Ann Indian Acad Neurol. 2013 Oct;16(4):549-55. doi: 10.4103/0972-2327.120463.
Our present observational study attempted to evaluate the clinical profiles, diagnosis, treatment and follow-up results of 51 pediatric neurocysticercosis patients over a mean duration of five years (from January 2006 to December 2010).
Diagnosis was mainly based on clinical features, computed tomography (CT)/magnetic resonance imaging scan and exclusion of other causes. Patients with active, transitional cysts and seizure were treated with albendazole for 28 days, steroids and anticonvulsants.
A total of 38 patients completed this study. Mean age of the presentation was 8.47 ± 3.19 years 52.6% of the patients were female. Overall patients presented with generalized seizure in 55.3%, focal in 31.6%, headache ± vomiting in 63.2%, focal neurodeficit in 10.5% and combination of symptoms in 60.5% cases. Contrast CT brain showed a solitary lesion in 27 (71.1%) and multiple in the rest. At presentation lesions were transitional in 58.2%, inactive in 20% and mixed in 14.6%. After a mean of 2 years, seizure persisted in 9 (23.7%) and headache in 8 (21.1%) of whom six had normal electroencephalography (EEG) while one each showed focal slowing, generalized slowing and epileptiform discharges. During the follow-up, CT scan brain 44.7% lesions calcified, 31.6% disappeared, 10.5% regressed and the rest persisted.
Solitary ring enhancing lesions (transitional stage) involving the parietal lobe was the commonest CT picture at presentation. Generalized tonic-clonic seizure was the most common type of seizure. Number of lesions, persistence of lesion, number of seizures, EEG abnormality at presentation were not found to be prognostically significant (P > 0.05).
我们目前的观察性研究试图评估51例儿童神经囊尾蚴病患者在平均五年时间（从2006年1月至2010年12月）内的临床特征、诊断、治疗及随访结果。
诊断主要基于临床特征、计算机断层扫描（CT）/磁共振成像扫描以及排除其他病因。活动性、过渡性囊肿且有癫痫发作的患者接受阿苯达唑治疗28天，并使用类固醇和抗惊厥药物。
共有38例患者完成本研究。就诊时的平均年龄为8.47±3.19岁，52.6%的患者为女性。总体而言，55.3%的患者出现全身性癫痫发作，31.6%为局灶性发作，63.2%有头痛伴呕吐，10.5%有局灶性神经功能缺损，60.5%的病例有症状组合。脑部增强CT显示，27例（71.1%）有单个病灶，其余为多个病灶。就诊时，58.2%的病灶处于过渡阶段，20%为非活动性，14.6%为混合型。平均2年后，9例（23.7%）仍有癫痫发作，8例（21.1%）仍有头痛，其中6例脑电图（EEG）正常，1例显示局灶性减慢，1例显示全身性减慢，1例显示癫痫样放电。随访期间，脑部CT扫描显示44.7%的病灶钙化，31.6%消失，10.5%缩小，其余病灶持续存在。
就诊时最常见的CT表现是累及顶叶的单个环形强化病灶（过渡阶段）。全身性强直阵挛发作是最常见的癫痫发作类型。未发现病灶数量、病灶持续存在情况、癫痫发作次数、就诊时的EEG异常具有预后意义（P>0.05）。
