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小儿神经囊尾蚴病

Pediatric neurocysticercosis.

作者信息

de Oliveira Ricardo Santos, Viana Dinark Conceição, Colli Benedicto Oscar, Rajshekhar Vedantam, Salomão José Francisco Manganelli

机构信息

Division of Neurosurgery and Pediatric Neurosurgery, Department of Surgery and Anatomy, University Hospital of Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil.

Department of Neurological Sciences, Christian Medical College Hospital, Vellore, India.

出版信息

Childs Nerv Syst. 2018 Oct;34(10):1957-1965. doi: 10.1007/s00381-018-3889-4. Epub 2018 Jul 9.

Abstract

BACKGROUND

Neurocysticercosis (NCC) is an infestation of the nervous system caused by encysted larvae of Taenia solium. NCC is an important acquired cause of epilepsy and other neurological manifestations especially in endemic areas. NCC in children has pleomorphic manifestations depending on the location, number, viability of the cysts, and host response. Even with advancing knowledge of the disease manifestations, many aspects related to diagnosis and treatment, particularly in children, still remain controversial and pose challenges to clinical practice. There is no gold standard test to diagnose NCC and the management recommendations are still emerging. This review provides an overview of diagnosis of NCC in children and its management with special focus on current challenges and future prospects.

DISCUSSION

In developing countries, NCC is important not only because of its frequency but also because of high morbidity and mortality rates associated, especially in cases in which it progresses to increased intracranial pressure. Because of its pleomorphic presentation, NCC should be considered in the differential diagnosis of a number of neurological conditions. Treatment with cysticidal therapy leads to reduction in seizure frequency and a faster resolution of lesions.

CONCLUSIONS

We have summarized the current approaches to diagnosis and treatment of NCC, recent advances in understanding the biology of NCC, and how one can take advantage of these new insights to formulate the next generation of clinical trials.

摘要

背景

神经囊尾蚴病(NCC)是由猪带绦虫的囊尾蚴寄生于神经系统引起的疾病。NCC是癫痫及其他神经症状的重要后天性病因,在流行地区尤为如此。儿童NCC的表现多样,取决于囊肿的位置、数量、活性以及宿主反应。尽管对该病的临床表现已有更多了解,但与诊断和治疗相关的许多方面,尤其是在儿童中,仍存在争议,并给临床实践带来挑战。目前尚无诊断NCC的金标准检测方法,治疗建议也仍在不断涌现。本综述概述了儿童NCC的诊断及其治疗,特别关注当前面临的挑战和未来前景。

讨论

在发展中国家,NCC不仅因其发病率高而重要,还因其相关的高发病率和死亡率,尤其是在病情进展为颅内压升高的病例中。由于其表现多样,在多种神经系统疾病的鉴别诊断中都应考虑NCC。使用杀囊尾蚴疗法进行治疗可降低癫痫发作频率,并使病灶更快消退。

结论

我们总结了目前NCC的诊断和治疗方法、在理解NCC生物学方面的最新进展,以及如何利用这些新见解来制定下一代临床试验。

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