ICNC Abstracts, ICNC 2018

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A prospective cohort study to assess seizure recurrences in children with calcified neurocysticercosis
Abhijit Modak, Renu Suthar, Jitendra Kumar Sahu, Naveen Sankhyan, Niranjan Khandelwal

Last modified: 2018-09-09

Abstract


Objective: Calcified neurocysticercosis (NCC) previously thought to be a dead end; is an important risk factor for seizure recurrences in children with parenchymal NCC. We studied the pattern of seizure recurrences and associated radiological features in children with calcified NCC.

Methodology: A prospective cohort study was conducted in the pediatric NCC clinic. Children between 1-18 years with calcified NCC were enrolled and divided in 2 groups; Denovo calcified and calcification on follow up. De novo calcified lesions were symptomatic children with a calcified lesion at first imaging.

Result: During study period, 520 children were screened and 128 children with calcified NCC were enrolled; and followed up for a median duration of 34 (IQR:18 - 49) months. Mean age was 10.8±3.2 years and 63% were boys. Among 128 children; 40 (31.3%) had denovo lesions. Seizure recurrence was noted in 61 (48.8%); 22 (57.9%) with denovo lesion and 39 (44.8%) with calcification on follow up. Seizure recurrence was associated with presence of perilesional edema in 57.4%, and contrast enhancement in 75% in whom MRI was done.  Drug refractory epilepsy was present in 18%. Median duration of epilepsy was significantly higher in children with calcification during follow up as compared to de novo calcified group (35 months vs 42 months, P<0.05)

Conclusion: Calcified NCC is an important risk factor of seizure recurrence in children with neurocysticercosis. Presence of perilesional edema and contrast enhancement was noted with seizure recurrence.

Keywords


Neurocysticercosis; Seizure recurrences; Calcified NCC; Perilesional edema; Contrast enhancement; Epilepsy; Drug refractory epilepsy;

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