Kumar Animesh, Mandal Anirban, Sinha Sheela, Singh Amitabh, Das Rashmi Ranjan
Department of Pediatrics, All India Institute of Medical Sciences, New Delhi 110029, India.
Department of Pediatrics, Sitaram Bhartia Institute of Science and Research, New Delhi 110016, India.
Int J Pediatr. 2017;2017:8983958. doi: 10.1155/2017/8983958. Epub 2017 Jan 10.
Neurocysticercosis (NCC) is the commonest cause of childhood acquired epilepsy in developing countries. The use of cysticidal therapy in NCC, except "single lesion NCC," is still debated in view of its doubtful usefulness and potential adverse effects. Children presenting with first episode of seizure or acute focal neurological deficit without fever were screened for NCC and received appropriate therapy (followup done for 1 year to look for the response and side effects). The prevalence of NCC was 4.5%. Most common presenting feature was generalized seizure and commonest imaging finding was single small enhancing lesion in the parietal lobe. Abnormal EEG and CSF abnormalities were found in almost half of the children. The response to therapy was very good with infrequent recurrence of seizure and adverse effects of therapy were encountered rarely. No risk factors for persistent seizure could be identified. Present study shows that the response to cysticidal therapy is very good in NCC as seizure recurrence was observed in only 5%, 4.2%, and 4.2% of cases at 3-month, 6-month, and 1-year followup. Adverse effects of therapy were observed in 20% of cases during therapy but they were mild and self-limiting.
神经囊尾蚴病（NCC）是发展中国家儿童后天性癫痫最常见的病因。鉴于其疗效存疑及潜在不良反应，除“单发病灶NCC”外，NCC中使用杀囊尾蚴疗法仍存在争议。对首次发作癫痫或出现无发热急性局灶性神经功能缺损的儿童进行NCC筛查并给予适当治疗（随访1年以观察疗效及副作用）。NCC患病率为4.5%。最常见的表现为全身性癫痫发作，最常见的影像学表现为顶叶单个小强化病灶。近半数儿童脑电图异常及脑脊液异常。治疗反应良好，癫痫复发罕见，治疗不良反应也很少见。未发现持续性癫痫的危险因素。本研究表明，NCC对杀囊尾蚴疗法反应良好，在3个月、6个月和1年随访时，癫痫复发率分别仅为5%、4.2%和4.2%。20%的病例在治疗期间出现治疗不良反应，但症状轻微且为自限性。
