Burden of neurocysticercosis-treatable but also preventable

How to cite this article:
Menon B, Goyal R. Burden of neurocysticercosis-treatable but also preventable. Ann Trop Med Public Health 2012;5:625-6

 

How to cite this URL:
Menon B, Goyal R. Burden of neurocysticercosis-treatable but also preventable. Ann Trop Med Public Health [serial online] 2012 [cited 2017 Nov 14];5:625-6. Available from: https://www.atmph.org/text.asp?2012/5/6/625/109344

Sir,

A 34-year-old male was bought to the neurology outpatient department with a single episode of generalized tonic-clonic (GTC) seizure. Patient has a generalized seizure lasting for one minute. There was no postictal confusion or headache. He did not have any past or family history of seizure. His neurological examination was normal.

Patient underwent a Magnetic resonance imaging (MRI) brain, which showed multiple small cystic lesions scattered in brain parenchyma [Figure 1]a-d with few lesions showing faint ring enhancement with scolex [Figure 1]e and f. The lesions were suggestive of neurocysticercosis (NCC). Patient was started on albendazole 15 mg/kg/day, steroids and phenytoin. Patient was asymptomatic on follow-up after one year. His repeat MRI showed near total resolution of the NCC [Figure 2].

Figure 1: (a-d). MRI T2 weighted study axial images show multiple cystic lesions in the cortical, subcortical and brain stem regions. (e,f) MRI T1 weighted contrast showing few lesions showing faint ring enhancement with scolex

Click here to view

Figure 2: MRI T2 weighted study axial images show few hypointense lesions in the right cerebellum suggestive of calcified lesions.

Click here to view

NCC is an important cause of acquired seizures. NCC is a parasitic infection acquired through consumption of food contaminated with feces of T. solium tapeworm carrier (i.e., through fecal-oral contract). [1],[2] Though, NCC occurs in developing countries, reports of NCC in west are fast increasing as a result of the immigration of infected persons from the endemic area. Once human ingests egg-contaminated food or water, the cysticerci spread through the small intestine to muscles, brain and subcutaneous tissues via blood stream.

Our patient had a single episode of GTC. After neurimaging, there was no relation between his infection load and his clinical status. In developing countries, prevention of central nervous system infections will reduce the burden of epilepsy. A study from India showed that NCC was the cause of active epilepsy in 1/3rd of all cases. [3]

NCC as a tropical disease is a public health issue, with common risk factors for transmission. Our patient had good clinical and radiological recovery on treatment. However, the epilepsy could have been prevented in him. Though, NCC is easy to control and eradicable, it still remains neglected. Proper health interventions with education, research, adequate health facilities will help in bringing down the burden of NCC and hence epilepsy.

References

 

1. Roman G, Sotelo J, Del Brutto O, Flisser A, Dumas M, Wadia N, et al. A proposal to declare neurocysticercosis an international reportable disease. Bull World Health Organ 2000;78:399-406.
2. Hotez PJ, Brown SA. Neglected tropical disease vaccines. Biologicals 2009;37:160-4.
3. Rajshekhar V, Raghava MV, Prabhakaran V, Oommen A, Muliyil J. Active epilepsy as an index of burden of neurocysticercosis in Vellore district, India. Neurology 2006;67:2135-9.

Source of Support: None, Conflict of Interest: None

Check

DOI: 10.4103/1755-6783.109344

Figures

[Figure 1], [Figure 2]

Paul Mies has now been involved with test reports and comparing products for a decade. He is a highly sought-after specialist in these areas as well as in general health and nutrition advice. With this expertise and the team behind atmph.org, they test, compare and report on all sought-after products on the Internet around the topics of health, slimming, beauty and more. The results are ultimately summarized and disclosed to readers.

LEAVE A REPLY

Please enter your comment!
Please enter your name here