Title: Study of Neurocysticercosis in the Pediatrics Ward of Atertiary Care Centre in Garhwal Region (Uttarakhand) India

Authors: Amit Kumar Singh, Govind Singh, Sandeep Gaur

 DOI:  http://dx.doi.org/10.18535/jmscr/v4i9.93

Abstract

Neurocysticercosis (NCC) is infestation of human central nervous system with tissue cysts of pork tapeworm Taeniasolium. Human beings acquire cysticercosis through faecal oral contamination with T. soliumeggs or poor hygiene practices in food handling by tapeworm carriers. Clinical presentation of NCC can be variable. Seizures are the commonest presentation of NCC. Various types of seizures have been described among patients with NCC including generalized, focal and rarely myoclonus and acquired epilepticaphasia. In general, it seems that about half thecases have partial seizures and the other half generalized seizures, a proportion similar to that of the general population. Neuroimaging is the mainstay of diagnosis of NCC. Lesions suggestive of NCC on CT, in patients with compatible clinical picture in endemic areas are usually diagnosed as NCC. The study was based on 540 total number of patients admitted with neurocysticercosis (NCC) over a period of three years. These all patients were admitted in department of pediatrics, VCSGGMS&RI (Government Medical College, Srinagar Garhwal), Uttarakhand. All Neuroim aging investigations were investigated in department of Radio diagnosis, Government medical college and hospital, Srinagar. Pathological and microbiological investigation also done in central lab of government medical college and Hospital, Srinagar.  All the patients were examined clinically and were investigated with neuro imaging. In addition to above X-Ray chest, Mantoux test, Hematological investigations including ESR and CSF was done to rule out Tuberculoma. Routine stool examination was also done. During our 3 years of study period NCC has emerged as an alarming public health problem of our region and its incidence has risen from 33.33% in 2012 to 42.26 % in 2014 in pediatric patients .The rising incidence could be due to high index of suspicion in every case presenting with seizures.

A strikingly high incidence of Neurocysticercosis (NCC) was found among the pediatric patients of our tertiary care hospital. A high incidence of NCC in this region reflects the endemic presence of Taeniasolium.

Keywords: Neurocysticercosis, Pediatric patients, Seizures, Taeniasolium ,Neurologic disease

References

1.      Sorvillo F, Wilkins P, Shafir S, Eberhard M. Public health implications of cysticer-cosis acquired in the United States. Emerg Infect Dis. Jan 2011; 17(1):1-6. 

2.      Zee CS, Go JL, Kim PE, DiGiorgio CM. Imaging of neurocysticercosis.  Neuro-imaging Clin N Am. May 2000; 10(2): 391-407. 

3.      Wallin MT, Kurtzke JF. Neurocystic-ercosis in the United States: review of an important emerging infection. Neurology. Nov 9 2004;63(9):1559-64. 

4.      Garcia HH, Del Brutto OH,. Neurocysticercosis: updated concepts about an old disease. Lancet Neurol. Oct 2005;4(10):653-61. 

5.      Chaoshuang L, Zhixin Z, Xiaohong W, Zhanlian H, Zhiliang G. Clinical analysis of 52 cases of neurocysticercosis. Trop Doct. Jul 2008;38(3):192-4. 

6.      Jung H, Cardenas G, Sciutto E, Fleury A. Medical treatment for neurocysticercosis: drugs, indications and perspectives. Curr Top Med Chem. 2008;8(5):424-33. 

7.      Ruiz-Garcia M, Gonzalez-Astiazaran A, Rueda-Franco F. Neurocysticercosis in children. Clinical experience in 122 patients. Childs Nerv Syst. Nov-Dec 1997;13(11-12):608-12. 

8.      Talukdar B, Saxena A, Popli VK. Neurocysticercosis in children: clinical characteristics and outcome. Ann Trop Paediatr. Dec 2002;22(4):333-9. 

9.      Carabin H, Ndimubanzi PC, Budke CM, Nguyen H, Qian Y, Cowan LD, et al. Clinical manifestations associated with neurocysticercosis: a systematic review.  PLoS Negl Trop Dis. May 2011;5 (5):e1152.

10.  Rosenfeld EA, Byrd SE, Shulman ST. Neurocysticercosis among children in Chicago. Clin Infect Dis. Aug 1996;23 (2):262-8. 

11.  Garcia HH, Parkhouse RM, Gilman RH, Montenegro T, Bernal T, Martinez SM, et al. Cysticercosis Working Group in Peru. Serum antigen detection in the diagnosis, treatment, and follow-up of neurocystice-rcosis patients. Trans R Soc Trop Med Hyg 2000; 94: 673-676.

12.  Shandera WX, Kass JS. Neurocysti-cercosis: current knowledge and advances. Curr Neuro lNeurosci Rep. Nov 2006; 6(6):453-9. 

13.  Singhi P, Singhi S. Neurocysticercosis in children. J Child Neurol. Jul 2004;19 (7):482-92. 

14.  Sinha S, Sharma BS. Neurocysticercosis: A review of current status and manage-ment. J ClinNeurosci. Apr 24 2009.

15.  Garg RK, Sinha MK. Multiple ring-enhancing lesions of the brain. J Postgrad Med. Oct-Dec 2010;56(4):307-16. 

16.  Fleury A, Hernandez M, Avila M, et al. Detection of HP10 antigen in serum for diagnosis and follow-up of subarachnoidal and intraventricular human neurocystic-ercosis. J Neurol Neurosurg Psychiatry. Sep 2007; 78(9):970-4. 

17.  Almeida CR, Ojopi EP, Nunes CM, et al. Taeniasolium DNA is present in the cerebrospinal fluid of neurocysticercosis patients and can be used for diagnosis. Eur Arch Psychiatry Clin Neurosci. Aug 2006; 256(5):307-10. 

18.  Rodriguez S, Dorny P, Tsang VC, Pretell EJ, Brandt J, Lescano AG. Detection of Taeniasolium antigens and anti-T. solium antibodies in paired serum and cerebrospinal fluid samples from patients with intraparenchymal or extraparenc-hymal neurocysticercosis. J Infect Dis. May 1 2009; 199(9):1345-52.

19.  Balaji J, D M. Clinical and Radiological Profile of Neurocysticercosis in South Indian Children. Indian J Pediatr. Mar 12 2011.

20.  Del Brutto OH, Sotelo J, Roman GC. Therapy for neurocysticercosis: a reappr-aisal. Clin Infect Dis 1993; 17:730-5.

Corresponding Author

Amit Kumar Singh

Assistant Professor, Dept of Pediatrics

V.C.S.G.GMSRI, Srinagar, Garhwal (Uttarakhand)

Email: This email address is being protected from spambots. You need JavaScript enabled to view it.