Singhi Pratibha, Suthar Renu, Deo Brijendra, Malhi Prabhjot, Khandelwal Niranjan K
From the *Department of Pediatrics, †Unit of Pediatric Neurology and Neurodevelopment, Department of Pediatrics, and ‡Department of radio diagnosis and imaging, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Pediatr Infect Dis J. 2017 Jun;36(6):549-555. doi: 10.1097/INF.0000000000001536.
Our aim was to study long-term clinical and radiologic outcome in children with parenchymal neurocysticercosis (NCC) and its predictors.
Five hundred children with NCC registered in the pediatric NCC clinic between January 1996 and December 2002 and followed till December 2009 were enrolled. Demographic details, clinical presentations and therapy received were recorded. Outcome was evaluated in terms of seizure recurrence and resolution of lesions on neuroimaging. Various factors that could influence outcome were studied.
Mean age at presentation was 8 ± 2.7 years, and the mean duration of follow-up was 8.8 ± 2.03 years; 79.6% (398) had single lesion, and 20.4% (102) had multiple lesions at presentation; 14.5% (58) of children with single lesion, and 28.4% (29) of children with multiple lesions had recurrent seizures (P < 0.001) during follow-up. At 6-month follow-up neuroimaging, resolution was seen in 52.7% (210) and 31.3% (32) of children with single and multiple lesions, respectively (P < 0.001). On prolonged follow-up, 94.6% (384) of single-lesion NCC and 88% (90) of multiple-lesion NCC (P < 0.001) had radiologic resolution. Single-lesion NCC, radiologic resolution and cysticidal therapy were associated with better seizure outcome (P < 0.05). Children with multiple lesions had significantly higher percentage of calcified lesions on long-term follow-up compared with those with a single lesion (11.7% vs. 3.6%, P < 0.05).
Children with a single-lesion NCC have favorable outcome with resolution of most of the lesions and few seizure recurrences. Cysticidal therapy leads to better seizure control and increased resolution of lesions on short-term follow-up.
我们的目的是研究实质性神经囊尾蚴病（NCC）患儿的长期临床和影像学结局及其预测因素。
纳入1996年1月至2002年12月在儿科NCC诊所登记并随访至2009年12月的500例NCC患儿。记录人口统计学细节、临床表现和接受的治疗。根据癫痫复发情况和神经影像学上病变的消退情况评估结局。研究了各种可能影响结局的因素。
就诊时的平均年龄为8±2.7岁，平均随访时间为8.8±2.03年；就诊时79.6%（398例）有单个病灶，20.4%（102例）有多个病灶；随访期间，单个病灶患儿中有14.5%（58例）、多个病灶患儿中有28.4%（29例）出现癫痫复发（P<0.001）。在6个月的随访神经影像学检查中，单个病灶患儿和多个病灶患儿中分别有52.7%（210例）和31.3%（32例）的病灶消退（P<0.001）。长期随访时，单个病灶NCC中有94.6%（384例）、多个病灶NCC中有88%（90例）出现影像学病灶消退（P<0.001）。单个病灶NCC、影像学病灶消退和杀虫治疗与更好的癫痫结局相关（P<0.05）。与单个病灶患儿相比，多个病灶患儿在长期随访时钙化病灶的比例显著更高（11.7%对3.6%，P<0.05）。
单个病灶NCC患儿的结局良好，大多数病灶消退，癫痫复发较少。杀虫治疗可在短期随访中更好地控制癫痫发作并增加病灶消退。
