Thomson A J, De Villiers J C, Moosa A, Van Dellen J
Ann Trop Paediatr. 1984 Jun;4(2):67-77. doi: 10.1080/02724936.1984.11748312.
Sixty-one children with cerebral cysticercosis are presented. The commonest clinical manifestation was epilepsy with or without focal signs in 43% of children, followed by the syndrome of raised intracranial pressure in 34% and meningoencephalitis in 13%. The CT scan was positive in 93% of cases and the HAI test in 86% of children so examined. Both were positive in 80%. Skull X-ray revealed evidence of calcification and/or raised intracranial pressure in 60%. Two children died, one each with subacute sclerosing panencephalitis and tuberculous meningitis. Of those who improved on discharge, 43% had epilepsy and 32% neurological deficit of an obvious nature. The parasitology, pathogenesis, pathology and diagnosis of cerebral cysticercosis are briefly reviewed. Present therapy and the suggested use of a specific anti-cysticeral drug are discussed. Case histories are presented to draw attention to the variability of the clinical picture and the particular importance of recognising the acute parenchymatous form of the disease in children which may present with critically elevated intracranial pressure.
本文报告了61例脑囊尾蚴病患儿。最常见的临床表现为癫痫，43%的患儿伴有或不伴有局灶性体征，其次是颅内压升高综合征，占34%，脑膜脑炎占13%。93%的病例CT扫描呈阳性，86%接受检查的患儿HAI试验呈阳性。两者均阳性的占80%。颅骨X线检查显示60%有钙化和/或颅内压升高的证据。两名患儿死亡，一名死于亚急性硬化性全脑炎，另一名死于结核性脑膜炎。出院时病情好转的患儿中，43%有癫痫，32%有明显的神经功能缺损。本文简要回顾了脑囊尾蚴病的寄生虫学、发病机制、病理学和诊断。讨论了目前的治疗方法以及建议使用的一种特异性抗囊尾蚴药物。通过病例报告提醒注意临床表现的变异性以及认识儿童急性实质性疾病形式的特别重要性，这种疾病可能伴有严重升高的颅内压。
