NEUROCYSTICERCOSIS AND AFEBRILE SEIZURE

Sir,

The report on “neurocysticercosis and afebrile seizure33. Sahu PS, Seepana J, Padela S, Sahu AK, Subbarayudu S, Barua A. Neurocysticercosis in children presenting with afebrile seizure: clinical profile, imaging and serodiagnosis. Rev Inst Med Trop Sao Paulo. 2014;56:253-8.” is very interesting. SAHU et al. noted that “neurocysticercosis should be suspected in every child presenting with afebrile seizure especially with a radio-imaging supportive diagnosis in tropical developing countries or areas endemic for teniasis/cysticercosis33. Sahu PS, Seepana J, Padela S, Sahu AK, Subbarayudu S, Barua A. Neurocysticercosis in children presenting with afebrile seizure: clinical profile, imaging and serodiagnosis. Rev Inst Med Trop Sao Paulo. 2014;56:253-8.”. In fact, neurocysticercosis is a very important tropical neurological infection. This disease can be seen worldwide. The MRI finding and immune response in neurocysticercosis is very interesting. KISHORE et al. found that “immune response was sub-optimal even in MRI positive cases and conversely, few MRI negative cases were seropositive11. Kishore J, Mukhopadhyay C, Pradhan S, Ayyagari A, Gupta RK. Neurocysticercosis in clinically suspected and MRI proven cases: evidence of sub-optimal antibody response. Indian J Pathol Microbiol. 2004;47:290-4..” Hence, to diagnose, both investigations are necessary11. Kishore J, Mukhopadhyay C, Pradhan S, Ayyagari A, Gupta RK. Neurocysticercosis in clinically suspected and MRI proven cases: evidence of sub-optimal antibody response. Indian J Pathol Microbiol. 2004;47:290-4.. Furthermore, there are many concerns on treatment of the neurocysticercosis presenting with afebrile seizure. First, the efficacy of antiparasitic drug might be reduced due to drug interaction with antiepileptic drug22. Na-Bangchang K, Vanijanonta S, Karbwang J. Plasma concentrations of praziquantel during the therapy of neurocysticerosis with praziquantel, in the presence of antiepileptics and dexamethasone. Southeast Asian J Trop Med Public Health. 1995;26:120-3.. To manage the case of neurocysticercosis, searching for possible infestation in other organs of the patient is suggested since disseminated infestation can be expected. Also, other concomitant parasitic infestation must be searched for.

REFERENCES

  • 1
    Kishore J, Mukhopadhyay C, Pradhan S, Ayyagari A, Gupta RK. Neurocysticercosis in clinically suspected and MRI proven cases: evidence of sub-optimal antibody response. Indian J Pathol Microbiol. 2004;47:290-4.
  • 2
    Na-Bangchang K, Vanijanonta S, Karbwang J. Plasma concentrations of praziquantel during the therapy of neurocysticerosis with praziquantel, in the presence of antiepileptics and dexamethasone. Southeast Asian J Trop Med Public Health. 1995;26:120-3.
  • 3
    Sahu PS, Seepana J, Padela S, Sahu AK, Subbarayudu S, Barua A. Neurocysticercosis in children presenting with afebrile seizure: clinical profile, imaging and serodiagnosis. Rev Inst Med Trop Sao Paulo. 2014;56:253-8.

Publication Dates

  • Publication in this collection
    Jan-Feb 2015
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