Noormahomed Emilia Virgínia, Nhancupe Noémia, Mufume Jerónimo, Schooley Robert T, Foyaca-Sibat Humberto, Benson Constance A
Department of Microbiology, Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique.
Department of Medicine, Infectious Disease Division, University of California, San Diego, California, USA.
EC Microbiol. 2021 Jul;17(6):49-56. Epub 2021 May 29.
Previous studies suggest that neurocysticercosis (NCC), the most common cause of acute symptomatic seizures (ASS), epilepsy and other neuropsychiatric disorders, typically presents with a solitary lesion and focal seizures in children from places where cysticercosis is endemic. We report a series of 3 patients, aged 7 to 11 years, with a history of epilepsy and or recurrent headache referred from Mocuba to the Quaternary Central Hospital in Quelimane, Zambeze Province, Mozambique, an area endemic for cysticercosis. Clinical history and examination, blood chemistry and hemogram screening, serological testing for Cysticercus antigens and antibodies detection, and a computerized tomography (CT) scan, were performed. NCC was confirmed in all 3 patients, based on criteria defined by Del Bruto. Two confirmed cases tested positive for antigen (Ag) by enzyme-linked immunosorbent assay (ELISA) with CT lesions in different stages of parasite evolution. Headache/encephalopathy was present in all patients. This case series of children with epilepsy confirms for the first time the presence of NCC in children from Zambezia province, an east-central region of Mozambique. Further, NCC should be included in the differential diagnosis of children with ASS, epilepsy and other neuropsychiatric disorders. Future studies should be targeted to the identification of biomarkers to support the diagnosis of NCC, given the limited availability of imaging tools and limited value of serological assays for the diagnosis and management of NCC.
先前的研究表明，神经囊尾蚴病（NCC）是急性症状性癫痫（ASS）、癫痫及其他神经精神疾病最常见的病因，在囊尾蚴病流行地区，儿童通常表现为单个病灶和局灶性癫痫发作。我们报告了3例年龄在7至11岁之间的患者，他们有癫痫和/或反复头痛病史，从莫库巴转诊至莫桑比克赞比西亚省克利马内的四级中心医院，该地区为囊尾蚴病流行区。进行了临床病史和检查、血液化学和血常规筛查、囊尾蚴抗原和抗体检测的血清学检测以及计算机断层扫描（CT）。根据德尔·布鲁托定义的标准，所有3例患者均确诊为NCC。2例确诊病例通过酶联免疫吸附测定（ELISA）检测抗原（Ag）呈阳性，CT显示寄生虫处于不同演变阶段的病灶。所有患者均有头痛/脑病症状。这一系列癫痫患儿病例首次证实了莫桑比克中东部赞比西亚省儿童中存在NCC。此外，NCC应纳入ASS、癫痫及其他神经精神疾病患儿的鉴别诊断。鉴于影像学工具有限且血清学检测对NCC诊断和管理的价值有限，未来的研究应致力于识别生物标志物以支持NCC的诊断。
