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Neurocysticercosis among children in Chicago
E A Rosenfeld1, S E Byrd, S T Shulman
1Department of Pediatric Infectious Diseases, Northwestern University Medical School, Chicago, Illinois, USA.
Insights
Neurocysticercosis, a pork tapeworm infection of the brain, is increasingly diagnosed in US children due to immigration. This study found it
Area of Science:
- Neurology
- Infectious Diseases
- Pediatrics
Background:
- Neurocysticercosis (NC) diagnosis is rising in the US, linked to immigration and travel from endemic regions.
- This retrospective study analyzes 47 pediatric cases of NC at a Chicago children's hospital.
Purpose of the Study:
- To describe the clinical, epidemiological, and radiographic features of pediatric neurocysticercosis.
- To evaluate diagnostic modalities and treatment outcomes in children with NC.
Main Methods:
- Retrospective analysis of 47 pediatric neurocysticercosis cases.
- Diagnostic criteria included surgical biopsy, serology/CSF titers with imaging, or imaging with compatible epidemiology.
- Data collected: epidemiologic, clinical, laboratory, and radiographic information.
Main Results:
- Neurocysticercosis is a common cause of afebrile seizures in children presenting to Chicago emergency departments.
- Both CT and MRI are crucial for evaluating pediatric neurocysticercosis.
- Laboratory studies showed limited sensitivity and predictive value for NC diagnosis.
Conclusions:
- Neurocysticercosis is an important consideration in pediatric seizure evaluations, particularly in immigrant populations.
- Imaging plays a vital role in diagnosing neurocysticercosis.
- Treatment for neurocysticercosis is well-tolerated with excellent long-term prognosis.
Abstract:
Neurocysticercosis has been diagnosed increasingly in the United States as a consequence of increased immigration from and travel to areas of endemic cysticercosis. We report a retrospective series of 47 pediatric cases of neurocysticercosis in our large children's hospital in Chicago, which has a large immigrant population. Neurocysticercosis was diagnosed on the basis of any of the following three criteria: (1) surgical biopsy findings, (2) radiographic findings consistent with neurocysticercosis as well as diagnostic serum and/or cerebrospinal fluid titers, or (3) consistent radiographic findings and a compatible epidemiologic history (without diagnostic serological findings). Epidemiologic, clinical, laboratory, and radiographic data were analyzed. Neurocysticercosis is a relatively common cause of afebrile seizures in children who present to our emergency department in Chicago. Computed tomography and magnetic resonance imaging are both important modalities in evaluation of children with neurocysticercosis. Laboratory studies are neither sensitive for nor predictive of the diagnosis of neurocysticercosis. Therapy is well tolerated. The long-term prognosis for treated patients appears to be excellent.