Incidence of seizures due to degenerative phase of neurocysticercosis: A study in a cohort of primary school children in south India

ABSTRACT

@#Objective: To study the incidence of seizures due to degenerative phase of neurocysticercosis (NCC) in a cohort of primary school children in south India. Methods: The study cohort included 7,408 (age 5-15 years, boys 44.5% and girls 55.5%) children registered on roles on the date of start of study. The children were followed through first to fifth standard for new-onset of seizures. The data collected included demographic data, date of seizure, any antecedent events, seizure semiology, neurologic findings, 40 minutes EEG findings, and contrast CT brain findings. This analysis is limited to seizures due to degenerative phase of NCC. The average annual incidence rates (AAIR) and 95% confidential intervals (CI) were calculated. Results: During the study period, of the 58 children with new-onset seizure, 19 (32.7%) had seizure due to degenerative phase of NCC [mean age 9.42 years; range7-13 years; 8 boys and 11 girls]. Contrast CT scans in all the 19 children showed solitary cysticercus granuloma (SCG). The common seizure type by mode of onset was focal. The AAIR of seizure disorder was 36.64 (95%CI 22.1-57.2) per 100,000. All the children received antiepileptic drug treatment and four weeks of albendazole and steroids. The seizure disorder resolved with the resolution of the lesion on follow-up CT scan and AEDs were withdrawn. Conclusions: In this highly selective cohort of primary school children from low economic strata, the AAIR of seizure disorder due to degenerative phase of NCC, SCG was high. Seizure disorder due to SCG has an enduring predisposition for seizure recurrence and need AEDs for the period of resolution of lesion and AEDs could safely be withdrawn with the resolution of the lesion.