Gupta Murli Manohar, Chaudhary Nagendra, Pathak Santosh, Agrawal Nikhil, Yadav Jaydev, Shrestha Sandeep, Kurmi Om Prakash, Bhatia Baldev, Agarwal Kailash Nath
Department of Pediatrics, Universal College of Medical Sciences, Bhairahawa 32900, Nepal.
Centre for Population Health and Research (CPR), Bhairahawa 32900, Nepal.
Int J Pediatr. 2018 May 21;2018:1030878. doi: 10.1155/2018/1030878. eCollection 2018.
Neurocysticercosis (NCC), a common cause of seizures in children from low and middle income countries (LMICs), if not diagnosed and treated early enough may lead to considerable morbidity and mortality. There is a lack of data on the prevalence of NCC and its clinical characteristics among those with seizure in South-Western Nepal.
To study the prevalence and clinical characteristics of NCC in children with seizures.
All children admitted to Universal College of Medical Sciences, a tertiary hospital in South-Western Nepal with seizures during 2014-16, were tested for NCC. NCC was diagnosed by neuroimaging [computerized tomography (CT) scan or magnetic resonance imaging (MRI)]. We used logistic regression to test the association between NCC with participants' characteristics and clinical symptoms.
Among 4962 in-patient children, 168 (104 boys and 64 girls) had seizures (138 with generalized tonic clonic seizures (GTCS) and 30 with focal seizures). 43% of children with seizures had CT scan confirmed NCC. The prevalence of NCC in the oldest children (13-16 years) was significantly greater (57.1% versus 15.6%) compared to the youngest (0-4 years) one ( < 0.001). Among 72 children with NCC, the proportions of children with vesicular, calcified, and colloidal stages were 76% ( = 35), 18% ( = 13), and 6% ( = 2), respectively. Children with focal seizures had 13% more NCC compared to those with GTCS but the result was statistically not significant. The adjusted odds of having NCC among 5-8 years, 9-12 years, and 13-16 years children were 6.6 (1.78-24.60), 11.06 (2.74-44.60), and 14.47 (3.13-66.96), respectively, compared to 0-4-year-old children. Reoccurrence of seizures within the first 3 months of taking antiepileptic drug in those with NCC was approximately 3 times higher compared to those without NCC (11% versus 4%, = 0.084).
This study shows that NCC contributes significantly to higher prevalence of seizures in children in South-Western region of Nepal.
神经囊尾蚴病（NCC）是低收入和中等收入国家（LMICs）儿童癫痫发作的常见原因，如果不及早诊断和治疗，可能导致相当高的发病率和死亡率。尼泊尔西南部癫痫患者中NCC的患病率及其临床特征的数据匮乏。
研究癫痫患儿中NCC的患病率及其临床特征。
对2014 - 2016年期间入住尼泊尔西南部一家三级医院——通用医学科学学院且有癫痫发作的所有儿童进行NCC检测。通过神经影像学[计算机断层扫描（CT）或磁共振成像（MRI）]诊断NCC。我们使用逻辑回归来检验NCC与参与者特征及临床症状之间的关联。
在4962名住院儿童中，168名（104名男孩和64名女孩）有癫痫发作（138名全身性强直阵挛发作（GTCS），30名局灶性发作）。43%的癫痫患儿经CT扫描确诊为NCC。年龄最大的儿童（13 - 16岁）中NCC的患病率显著高于年龄最小的儿童（0 - 4岁）（57.1%对15.6%，<0.001）。在72名NCC患儿中，处于囊泡期、钙化期和胶样期的儿童比例分别为76%（=35）、18%（=13）和6%（=2）。局灶性发作的儿童患NCC的比例比全身性强直阵挛发作的儿童高13%，但结果无统计学意义。与0 - 4岁儿童相比，5 - 8岁、9 - 12岁和13 - 16岁儿童患NCC的校正比值比分别为6.6（1.78 - 24.60）、11.06（2.74 - 44.60）和14.47（3.13 - 66.96）。服用抗癫痫药物的前3个月内，NCC患儿癫痫复发率比无NCC患儿高约3倍（11%对4%，=0.084）。
本研究表明，NCC是尼泊尔西南部地区儿童癫痫患病率较高的重要原因。
