Neurocysticercosis

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CLINICAL PROFILE OF CHILDHOOD NEURO
CYSTICERCOSIS
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Presentation By
Dr. P.Yashodhara M.D
Asst. Professor of Pediatrics
Guntur Medical College,Guntur
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Dr. M. ANIL MOHAN M.D. DCH PROFESSOR OF
PEDIATRICS GOVERNMENT GENERAL HOSPITAL GUNTUR Dr.
H. S. V. S. SASTRY MD. DCH. PROFESSOR AND HEAD
OF THE DEPARTMENT OF PEDIATRICS GOVERNMENT
GENERAL HOSPITAL GUNTUR
Dr. V. RAMATARAKNATH M.D. DM. PROFESSOR
OF NEUROLOGY GOVERNMENT GENERAL HOSPITAL GUNTUR
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• MATERIAL AND METHODS
• CHILDREN WITH UNPROVOKED SEIZURES 1 TO 12 YEARS
  ATTENDED DEPT. OF PED. GGH GUNTUR FROM SEPT,
  2000 TO AUG ,2001.
• - HISTORY AND CLINICAL EXAMINATION
• ROUTINE INVESTIGATION
• C. T. SCAN BRAIN PLAIN / CONTRAST
• (HYPODENSE , RING ENHANCING , DISC ENHANCING)

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• OBSERVATIONS
• TOTAL NUMBER OF O. P. CASES 54066
• TOTAL No. OF CASES ADMITTED FROM
  SEPTEMBER 2000 TO AUGUST 2001 3093 ( 1)
• TOTAL NO. OF CASES ADMITTED WITH
• SEIZURES 148
• NO. OF CASES PROVED TO BE NCC 31

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RESULTS AGE DISTRIBUTION

• NO. OF CASES lt 5 YRS 9
  29.03
• gt 5 YEARS 22 70.97
• MAXIMUM NO. OF CASES SEEN AROUND
• 12 YEARS AGE GROUP

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SEX DISTRIBUTION
SOCIO ECONOMIC GROUPS
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FOOD HABITS
CLINICAL PRESENTATIONS
1.SEIZURES
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2. HEADACHE 11(35.5) 3.VOMITINGS 8
CASES (25.8) 4.FEVER 4 CASES
(12.9) 5.PYRAMIDAL TRACT SIGNS 2 CASES
(6.5) 6.CRANIAL NERVE INVOLVEMENT UMN TYPE
OF FACIAL WEAKNESS - 1 (3.2) 7.PAPILLOEDEMA
EARLY PAPILLOEDEMA 1 (3.2) 8.CEREBELLAR
SIGNS NOT SEEN 9.HYDROCEPHALUS
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10.LATERALISATION
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SITE OF LESION Vs TYPE OF SEIZURES
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• DISCUSSION
• IN OUR INSTITUTE
• 1 OF TOTAL ADM. IN 1 YEAR NCC
• COMMON IN RURAL 29 (93.6)
• URBAN 2 (6.5)
• COMMON IN LOW SOCIOECONOMIC 29 (93.6)
• MIDDLE 1 (3.2) HIGH 1 (3.2)
• VEG 16 (51.6)
• NON.VEG 15 (48.4)
• AGE
• gt 5 YEARS 22 (70.97 )
• lt 5 YEARS 9 (29.03)

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COMPARITIVE STUDY OF NCC IN RESPECT TO CLINICAL
AND C.T
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PARENCHYMAL LESIONS ARE COMMON (KALRA VEENA
ASIAN JOURNAL OF PEAD. JULY SEPT
97) Clinical Profile SEIZURES PARTIAL
- COMMON (PURI ET AL NOV 91 I. P.)
PARTIAL SEIZURES - SOLITARY MULTIPLE
LESIONS - GS (Or) CPS WITH SEC. GEN.
?ICP - MULTIPLE LESIONS WITH EXTENSIVE
PERIFOCAL EDEMA (6/10) (60) (CORRELATED WITH
PURI ET AL)
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• C.T.FINDINGS
• SINGLE LESIONS 21 (67.7) - COMMONEST
  (CORRELATED WITH STUDY OF KALRA SETHI - 92)
  
• COMMON SITE - PARIETAL LOBE 14 (45.2)
• FOLLOWED BY FRONTO PARIETAL 4 (12.9)
• PARIETAL LOBE LESIONS SPS COMMON
  8/1(57.1)
• FROTOPARIETAL LESIONS - CPS COMMON.
  AND FRONTAL
• MULTIPLE LESIONS GS (OR) CPS COMMON

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LATERALISATION (PURI ET AL) RT SIDE
LESIONS 11 LT SIDE -- 10
SUPPORTIVE DIAGNOSIS BY STOOL MICROSCOPY
ADULT WORMS

PROGLATTIDS.
BIOPSY AND
HPE OF THE TISSUE ELISA USING IgG or IgM -
Not available in our institute
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• TREATMENT
• TREATMENT OF SEIZURES IS RECOMMENDED FOR AT
  LEAST 12-18 MONTHS PERIOD WITH SINGLE A E D
  PHENYTOIN OR CARBAMAZEPINE IS THE CHOICE.
• OUR RECENT OBSERVATIONS
• SHORTER COURSE OF A E D FOR 6 MONTHS
• ?ICP WITH STEROIDS FOR 1 WEEK
• ALBENDAZOLE 15 mg/Kg FOR 2-3 WKS
• ( BUT CRUZ et al OBSERVED 8 DAY COURSE
• OF AIBENDAZOLE IS EFFECTIVE)

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• SUMMARY
• THE INCIDENCE OF NCC
• lt 5YRS IS LOW 9 (29.03)
• gt5 YRS IS HIGH 22 (70.9)
• 2. THERE IS NO SEX PREDILECTION .
• 3. THE INC. IS HIGH IN LOW SOCIOECONOMIC
• GROUPS AND IN RURAL AREAS
• 4. BOTH VEG/NON-VEG ARE EQUALLY AFFECTED

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5. SEIZURE TYPES PARTIAL -- COMMON
SOLITARY - SPS COMMON MULTIPLE CPS OR GS
COMMON 6. ? ICP -- COMMON -- MULTIPLE
7.COMMONEST SITE PARIETAL LOBE FOLLOWED BY
FRONTO PARIETAL REGION 8.PARIETAL LOBE LESIONS
SPS FRONTO PARIETAL AND FRONTAL -- CPS
9.NEUROLOGICAL SIGNS LESS COMMON
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10. THOUGH SEROLOGICAL TESTS HPE ARE
IMPORTANT IN DIAGNOSIS OF NCC, BUT THEIR
NON-AVAILABILITY AND COST, C. T. PLAYS AN
IMP. ROLE IN DIAGNOSIS OF NCC 11.THE
OUTLOOK IS VERY GOOD BECAUSE OF IMPROVED
NEUROIMAGING AND THERAPAUTIC
MODALITIES 12. NO SEQUELAE WERE LEFT IN ALL NCC
CASES AFTER TREATING WITH STEROIDS ,
ALBENDAZOLE FOR 2-3 WEEKS AND A E D FOR 6
MONTHS
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Thank You All