ABSTRACT
The study was carried out for one year to find out the role of magnetic resonance imaging brain in pediatric patients with partial seizures. Children from age 28 days to 18 years who presented with partial seizures were included and the information obtained from the history, clinical examination and investigations particularly MRI brain were noted down and analyzed.Maximum numbers of patients were in the age group of 5-10 years (48.84%).27.91% had simple seizures and the rest 72.09%had complex partial seizures with none having secondary generalization. The risk factor for seizures were present in 54.19% of cases. Most of the lesions involved parietal region (44.19%) followed by temporal lobe involvement in 13.95%. 55.81% had findings of neurocysticercosis (NCC), 29.91% showed tuberculoma, 8.30% had normal MRI findings and 6.98% had findings suggestive of cerebritis, sturge weber syndrome and porencephalic cyst. 89.74% lesions showed contrast enhancement on MRI. Contrast enhancement MR altered the radiological diagnosis in many patients with partial seizures. It helped to diagnose infections like tuberculoma and NCC in various stages of evolution and also helped to rule out other structural lesions, thus helping in planning modalities of treatment.
ABSTRACT
Neurocysticercosis (NCC) is a common cause of seizures and neurologic disease. Although there may be variable presentations depending on the stage and location of cysts in the nervous system, most children (> 80%) present with seizures particularly partial seizures. About a third of cases have headache and vomiting. Diagnosis is made by either CT or MRI. Single enhancing lesions are the commonest visualization of a scolex confirms the diagnosis. Some cases have multiple cysts with a characterstic starry-sky appearance. Management involves use of anticonvulsants for seizures and steroids for cerebral edema. The use of cysticidal therapy continues to be debated. Controlled studies have shown that cysticidal therapy helps in increased and faster resolution of CT lesions. Improvement in long - term seizure control has not yet been proven. Children with single lesions have a good outcome and seizure recurrence rate is low. Children with multiple lesions have recurrent seizures. Extraparenchymal NCC has a guarded prognosis but it is rare in children. In endemic areas NCC must be considered in the differential diagnosis of seizures and various other neurological disorders.
Subject(s)
Adrenal Cortex Hormones/therapeutic use , Age Factors , Animals , Anticonvulsants/therapeutic use , Brain Diseases/diagnosis , Brain Diseases/drug therapy , Brain Diseases/etiology , Brain Diseases/mortality , Brain Edema/etiology , Brain Edema/prevention & control , Child , Child, Preschool , Electroencephalography , Female , Humans , Imaging, Three-Dimensional , Magnetic Resonance Imaging/methods , Male , Neurocysticercosis/complications , Neurocysticercosis/drug therapy , Neurocysticercosis/mortality , Neurocysticercosis/diagnostic imaging , Prognosis , Risk Assessment , Seizures/drug therapy , Seizures/etiology , Seizures/diagnostic imaging , Severity of Illness Index , Sex Factors , Survival Rate , Tomography, X-Ray ComputedABSTRACT
Objective To explore immunological mark and the outcome of disease after pharmacological treatment in human NCC with praziquantel. Methods 35 patients were treated with praziquantel for 6 months. Levels of serum IL-2,IFN-γ, IL-12, IL-5, IL-10 and TNF-α were measured before and after treatment. Results Th1 type cytokines IL-2, IFN-γand IL-12 were up regulated after treatment( P ＜ 0. 01 ) . Levels of TNF-α and Th2 type cytokines IL-5 and IL-10 were remarkable decreased after treatment( P ＜ 0. 01 ). The levels of IL-2, IFN-γ and IL-12 from the patients with good response to the treatment is higher than those with no response to the treatment. Conclusion Th1 type cytokines were up regulated while Th2 type cytokines were down regulated in the NCC patients treated with praziquantel. The protective immunity may be related to the Thl cell activation.