A Comparative Study of Single Versus Multiple Cysts of Neurocysticercosis Based on their Clinico-Serological Profile

Abstract

Introduction: Neurocysticercosis (NCC) is a common disease in developing countries. Its diagnosis is based on clinical, epidemiological, imaging findings and laboratory tests. Aim: To study and compare the clinical profile and diagnostic utility of NCC IgG ELISA in patients with single and multiple neurocysticercosis. Materials and Methods: This cross-sectional study was conducted in the Department of General Medicine, Himalayan Institute of Medical Science (HIMS), Swami Ram Nagar, Dehradun, over a period of 12 months from August 2014 to July 2015. Patients were grouped into those with single NCC and multiple NCC based on their radio imaging findings. A total number of 60 patients, 30 in each group were taken in the study and their clinical profiles were studied. Serum Immunoglobulin G(IgG) Enzyme-Linked Immunosorbent Assay (ELISA) test was applied on both the groups and serological profile was thus compared. Results: Most commonly affected age group was 18 to 35 years of age (60%). Most common symptom at presentation was seizure (53%). Out of 60 patients, 39 suffered from generalized tonic-clonic seizures. Status epilepticus was found exclusively in patients with multiple NCC (26.6%). Sensitivity of serum IgG ELISA was 53.3% amongst single NCC and 76.7% amongst multiple NCC. Conclusion: NCC may present with varied clinical features. No sign or symptom is pathognomic of the disease entity. Diagnostic tests are the only method to clinch the diagnosis. Detection of specific antibodies in patients with NCC is a useful tool for diagnosis, especially when radio imaging facilities are not available or inconclusive. Serological tests are useful if they are positive. Negative tests, however, do not exclude the diagnosis of NCC.

Keywords

• idiopathic epilepsy
• status epilepticus
• taenia solium
• tonic-clonic seizures