Affiliations: Department of Pediatrics, Manipal College of Medical
Sciences & Manipal Teaching Hospital, Phulbari, Pokhara, Nepal
Note: [] Correspondence: Sriparna Basu, MD, Department of Pediatrics,
Institute of Medical Sciences, Banaras Hindu University, Varanasi-221005,
India. Tel.: +91 9935340260; E-mail: drsriparnabasu@rediffmail.com
Abstract: Neurocysticercosis (NCC) is a very common pediatric neurological
problem in Western Nepal. Its magnitude is not adequately known as in most
situations it remains as an iceberg. To define the problem a retrospective
study of the clinical profile, response to treatment and follow-up of the
pediatric cases was done. Hospital records of inpatients admitted in the last 4
years (2000–2003) with the diagnosis of NCC were reviewed. Diagnosis was
primarily based on clinical features, computed tomography (CT) scan features
and exclusion of other causes. All patients were treated with 28 days' course
of albendazole, anti-edema drugs and anticonvulsants. Follow-up period varied
from 1 to 3 years. The medical records of 124 children with NCC were evaluated.
The most common age group affected was 10–12 years with the youngest patient
of 11 months. Partial seizure was the most prominent presentation. The most
frequent finding in CT scan was single ring-enhancing lesion with perilesional
edema affecting the parietal lobe. Twenty patients were lost to follow up.
Ninety-eight patients had complete clinical response and 87 of them had
complete disappearance of lesion in CT scan at the end of 1 year. Recurrence of
seizure was the only residual symptom found in six (4.8% patients, all of
them having calcified lesions in CT scan. In areas where NCC is endemic,
partial seizure in the pediatric age group is highly suggestive and should be
considered as a potential indicator of the disease. Considering the lower cost
and easy availability, CT scan remains the best investigation for confirmation
of diagnosis in a developing country like Nepal. The disease is usually
completely curable. Recurrent partial seizure is the only residual symptom,
which may occur more commonly in patients with calcified lesions.
