A retrospective analysis of variability of clinical presentations and brain imaging findings in children with neurocysticercosis in rural population of West Bengal

Abstract

Background: Neurocysticercosis (NCC) is a common, widely prevalent parasitic infestation of the central nervous system in children of developing countries leading to neurological morbidities. Objectives: To study the variability of initial clinical presentations and brain imaging findings in children with NCC in the rural population of West Bengal. Methods: A retrospective analysis was done in the Department of Pediatric Medicine, Burdwan Medical College, Burdwan, India from August 2011 to August 2013. Results: Out of 952 admitted children with seizure, 113 children were diagnosed as having NCC (11.9%). Out of them, 62 (54.9%) were boys and 51 (45.1%) were girls. The age of presentation varied from 3 years to 12 years, with mean age 9.4 years. The commonest age of presentation was between 10 to 12 years (n=62; 54.9%). The maximum number of patients were from Burdwan district (n=72; 63.7%) followed by Birbhum (n=25; 22.1%). The commonest initial presentation with seizure (n=93; 82.3 %); partial seizure were present in 76 patients (81.7%). On brain imaging study, the commonest location of lesions was found in the parietal region (n=69; 61.1 %), the right parietal region being more common. Single lesions were found in 102 patients(90.3%). Conclusion: NCC is a major cause of neurological morbidity in children of developing nations and it should be suspected in any children presenting with a first episode of afebrile partial seizure. A screening brain imaging should be performed earlier to prevent undue mortality and morbidity.

Neurocysticercosis in Children with Seizures: A Cross-Sectional Study

“…We noticed increased prevalence (59.7%) of NCC amongst the older children (9–16 years group) compared to only 9.7% in younger (0–4 years) age group. Our results are consistent with findings from some previous studies [ 8 , 21 ]. A study carried out by Shrestha et al [ 12 ] from Nepal in school going children reported the highest prevalence of NCC (48%) in the 10–15 years age groups.…”

“…A similar study carried out in Kathmandu, a hilly region of Nepal, reported that 16% of children with seizures had NCC and various studies from India have reported its prevalence to be in the range of 12–35% suggesting wide variability of NCC in different geographical regions [ 8 – 11 ]. The high prevalence may be due to number of factors such as high consumption of pork meat, rearing of pigs, consumption of raw vegetables, and lack of personal and environmental hygiene and sanitation.…”

“…Sample size ( n = 162) was calculated “anticipating 11.9% prevalence of neurocysticercosis in epilepsy patients [ 8 ] to fall within 10% points of true proportion with 95% confidence interval.” Data was recorded in predesigned pro forma. Patients were followed up in 3 months' time following administration of antiepileptic drugs (AEDs).…”

Clinico-Radiological Profile of Neurocysticercosis in Children

“…9 Similarly another study done in West Bengal, India concluded that parietal region specially on the right side was most commonly involved (61.1%). 8 Patil et al concluded that 45 % of cases had lesions in parietal lobe followed by frontal lobe involvement in 22.5 % of the cases. 12 In a study conducted in Gandaki Medical College, Nepal, about 61.2% of the lesions were found in parietal lobe.…”

“…also found nearly 70% cases between five to nine years age group and six to 10 years age group respectively 5,7. A study in rural population of West Bengal found commonest age being a little higher than as observed by M.S Pandit et al and Yadav et al 54.9% cases were between 10 to 12 years of age 8. A study done in Rohilkhand Medical College, Bareilly on 62 subjects in the year 2013 to 2014…”