del Brutto O H
Departamento de Neurología, Hospital Luis Vernaza, Guayaquil, Ecuador.
Rev Neurol. 1997 Nov;25(147):1681-4.
We studied 54 patients younger than 17 years of age with neurocysticercosis to determine the clinical manifestations, neuroimaging findings, and prognostic factors of this condition.
Seizures were present in 48 patients, representing the most common clinical manifestation. Forty-eight patients had a normal neurological examination, and only 3 patients had clinical evidence of increased intracranial pressure. CT scan of the brain revealed parenchymal brain cysticerci in 52 patients; one patient had a pure subarachnoid form of the disease and the remaining patient had a mixed (subarachnoid and parenchymal) form. The most common CT finding in patients with parenchymal neurocysticercosis was a single colloidal cyst (19 cases). All patients with seizures were treated with anti-epileptic drugs with an excellent rate of seizure-control. In addition, 23 patients received albendazole that caused resolution of cystic lesions in 19 cases. Anti-epileptic drugs were withdrawn in 13 patients who remained free of seizures during two years. However, 9 (69%) of these patients had recurrent seizures.
This evidence is in contrast with the reported benign course of neurocysticercosis in children, since most patients had seizure relapses despite therapy.
我们研究了54例年龄小于17岁的神经囊尾蚴病患者,以确定该疾病的临床表现、神经影像学表现及预后因素。
48例患者出现癫痫发作,这是最常见的临床表现。48例患者神经系统检查正常,只有3例有颅内压升高的临床证据。脑部CT扫描显示52例患者有脑实质囊尾蚴;1例患者为单纯蛛网膜下腔型疾病,其余患者为混合型(蛛网膜下腔和脑实质型)。脑实质型神经囊尾蚴病患者最常见的CT表现是单个胶样囊肿(19例)。所有癫痫发作患者均接受抗癫痫药物治疗,癫痫控制率极佳。此外,23例患者接受了阿苯达唑治疗,其中19例囊肿性病变消退。13例在两年内未再发作癫痫的患者停用了抗癫痫药物。然而,这些患者中有9例(69%)癫痫复发。
这一证据与报道的儿童神经囊尾蚴病的良性病程相反,因为大多数患者尽管接受了治疗仍有癫痫复发。