Background: Neurocysticercosis (NCC), a common cause of seizures in children from low and middle income countries (LMICs), if not diagnosed and treated early enough may lead to considerable morbidity and mortality. There is a lack of data on the prevalence of NCC and its clinical characteristics among those with seizure in South-Western Nepal.
Aims and Objectives: To study the prevalence and clinical characteristics of NCC in children with seizures.
Material and Methods: All children admitted to Universal College of Medical Sciences, a tertiary hospital in South-Western Nepal with seizures during 2014-16, were tested for NCC. NCC was diagnosed by neuroimaging [computerized tomography (CT) scan or magnetic resonance imaging (MRI)]. We used logistic regression to test the association between NCC with participants' characteristics and clinical symptoms.
Results: Among 4962 in-patient children, 168 (104 boys and 64 girls) had seizures (138 with generalized tonic clonic seizures (GTCS) and 30 with focal seizures). 43% of children with seizures had CT scan confirmed NCC. The prevalence of NCC in the oldest children (13-16 years) was significantly greater (57.1% versus 15.6%) compared to the youngest (0-4 years) one (p < 0.001). Among 72 children with NCC, the proportions of children with vesicular, calcified, and colloidal stages were 76% (n = 35), 18% (n = 13), and 6% (n = 2), respectively. Children with focal seizures had 13% more NCC compared to those with GTCS but the result was statistically not significant. The adjusted odds of having NCC among 5-8 years, 9-12 years, and 13-16 years children were 6.6 (1.78-24.60), 11.06 (2.74-44.60), and 14.47 (3.13-66.96), respectively, compared to 0-4-year-old children. Reoccurrence of seizures within the first 3 months of taking antiepileptic drug in those with NCC was approximately 3 times higher compared to those without NCC (11% versus 4%, p = 0.084).
Conclusions: This study shows that NCC contributes significantly to higher prevalence of seizures in children in South-Western region of Nepal.