RESUMO
Neurocysticercosis (NCC) is one of the major causes of childhood seizures in developing countries including India and Latin America. In this study neurological pediatric cases presenting with afebrile seizures were screened for anti-Cysticercus antibodies (IgG) in their sera in order to estimate the possible burden of cysticercal etiology. The study included a total of 61 pediatric afebrile seizure subjects (aged one to 15 years old); there was a male predominance. All the sera were tested using a pre-evaluated commercially procured IgG-ELISA kit (UB-Magiwell Cysticercosis Kit ™). Anti-Cysticercus antibody in serum was positive in 23 of 61 (37.7%) cases. The majority of cases with a positive ELISA test presented with generalized seizure (52.17%), followed by complex partial seizure (26.08%), and simple partial seizure (21.73%). Headaches were the major complaint (73.91%). Other presentations were vomiting (47.82%), pallor (34.78%), altered sensorium (26.08%), and muscle weakness (13.04%). There was one hemiparesis case diagnosed to be NCC. In this study one child without any significant findings on imaging was also found to be positive by serology. There was a statistically significant association found between the cases with multiple lesions on the brain and the ELISA-positivity (p = 0.017). Overall positivity of the ELISA showed a potential cysticercal etiology. Hence, neurocysticercosis should be suspected in every child presenting with afebrile seizure especially with a radio-imaging supportive diagnosis in tropical developing countries or areas endemic for taeniasis/cysticercosis.
Assuntos
Anticorpos Anti-Helmínticos/sangue , Neurocisticercose/diagnóstico , Convulsões Febris/parasitologia , Taenia solium/imunologia , Adolescente , Animais , Criança , Pré-Escolar , Ensaio de Imunoadsorção Enzimática , Feminino , Humanos , Lactente , Masculino , Neurocisticercose/complicações , Tomografia Computadorizada por Raios XRESUMO
Neurocysticercosis (NCC) is one of the major causes of childhood seizures in developing countries including India and Latin America. In this study neurological pediatric cases presenting with afebrile seizures were screened for anti-Cysticercus antibodies (IgG) in their sera in order to estimate the possible burden of cysticercal etiology. The study included a total of 61 pediatric afebrile seizure subjects (aged one to 15 years old); there was a male predominance. All the sera were tested using a pre-evaluated commercially procured IgG-ELISA kit (UB-Magiwell Cysticercosis Kit ™). Anti-Cysticercus antibody in serum was positive in 23 of 61 (37.7%) cases. The majority of cases with a positive ELISA test presented with generalized seizure (52.17%), followed by complex partial seizure (26.08%), and simple partial seizure (21.73%). Headaches were the major complaint (73.91%). Other presentations were vomiting (47.82%), pallor (34.78%), altered sensorium (26.08%), and muscle weakness (13.04%). There was one hemiparesis case diagnosed to be NCC. In this study one child without any significant findings on imaging was also found to be positive by serology. There was a statistically significant association found between the cases with multiple lesions on the brain and the ELISA-positivity (p = 0.017). Overall positivity of the ELISA showed a potential cysticercal etiology. Hence, neurocysticercosis should be suspected in every child presenting with afebrile seizure especially with a radio-imaging supportive diagnosis in tropical developing countries or areas endemic for taeniasis/cysticercosis.
Neurocisticercose é uma das causas mais comuns de crises em crianças em países em desenvolvimento incluindo Índia e América Latina. Neste estudo casos neurológicos pediátricos, apresentando crises afebris foram selecionados através de anticorpos anti-Cysticercus (IgG) no seu soro para avaliar possível etiologia de Cysticercus. O estudo incluiu total de 61 casos pediátricos de indivíduos com crises afebris (idade de um a 15 anos); houve predominância de pacientes do sexo masculino. Todos os soros foram testados usando um kit comercial IgG-ELISA (UB-Magiwell Cysticercosis kit™) avaliado previamente. O anticorpo anti-Cysticercus no soro foi positivo em 23 de 61 casos (37,7%). A maioria dos casos com teste de ELISA positivo apresentava crises generalizadas (52,17%), seguida por casos de crises parciais complexas (26,08%) e crises parciais simples (21,73%). Dores de cabeça foram a queixa principal (73,91%). Outras manifestações foram vômitos (47,82%), palidez (34,78%), sensório alterado (26,08%) e fraqueza muscular (13,04%). Houve um caso de hemiparesia diagnosticado como NCC. Neste estudo uma criança sem quaisquer achados significantes às imagens apresentou sorologia positiva. Houve associação estatística significante entre os casos com múltiplas lesões no cérebro e a positividade pelo ELISA (p = 0,017). No seu conjunto a positividade pelo ELISA demonstra etiologia potencial para a cisticercose. Portanto neurocisticercose deve ser suspeitada em qualquer criança apresentado crises afebris com imagem que sugira diagnóstico em países tropicais em desenvolvimento ou em áreas endêmicas para teníase/cisticercose.