Pediatric Neurology and Neurodevelopment Unit, Medanta, The Medicity, Gurgaon, Haryana, India.
Pediatric Neurology and Neurodevelopment Unit, Department of Pediatrics, Advanced Pediatrics Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Indian J Pediatr. 2019 Jan;86(1):76-82. doi: 10.1007/s12098-017-2460-8. Epub 2017 Sep 20.
Neurocysticercosis is the most common helminth infection of nervous system in humans caused by the encysted larvae of Taenia solium. It is a major cause of epilepsy in tropical areas and the most common cause of focal-onset seizures in North Indian children. Children with neurocysticercosis have pleomorphic manifestations depending on the location, number and viability of the cysts and host response. In endemic areas, neurocysticercosis should be clinically suspected in any child with recent-onset seizures, headache or focal motor deficits where there is no other suggestion of an underlying neurological disorder. Diagnosis of neurocysticercosis is essentially based on neuroimaging; visualization of a scolex is diagnostic. Management includes use of cysticidal drugs usually albendazole, which seems to be effective for lesion resolution and seizure remission, use of steroids and anti-epileptic drugs. Single lesions portend good prognosis with resolution of lesions in >60% of the cases within 6 mo and good seizure control. Prognosis is guarded in cysticercus encephalitis, racemose and extraparenchymal neurocysticercosis.
脑囊虫病是由猪带绦虫幼虫囊尾蚴引起的最常见的人类神经系统蠕虫感染。它是热带地区癫痫的主要病因,也是北印度儿童局灶性发作的最常见病因。脑囊虫病患儿的表现多样,取决于囊肿的位置、数量和活力以及宿主的反应。在流行地区,任何有近期发作性癫痫、头痛或局灶性运动障碍的儿童,如果没有其他潜在神经障碍的提示,都应临床怀疑患有脑囊虫病。脑囊虫病的诊断主要基于神经影像学;头节的可视化是诊断依据。治疗包括使用杀虫药物,通常是阿苯达唑,这似乎对病变的消退和癫痫的缓解有效,同时使用类固醇和抗癫痫药物。单一病变预示着良好的预后,>60%的病例在 6 个月内病变消退,癫痫得到良好控制。在囊虫性脑炎、脑实质多发性和脑外囊虫病中,预后较差。