Epidemiologic classification of seizures associated with neurocysticercosis: observations from a sample of seizure disorders in neurologic care in India.
OBJECTIVE
To determine the etiologic role of neurocysticercosis (NC) in a hospital-based sample of epilepsies divided according to International League Against Epilepsy (ILAE) epidemiological criteria and number of seizures prior to presentation.


METHODS
A sample comprising 1026 consecutive patients with either definite seizures or epilepsy attending a Neurology Outpatient Service was divided into four subgroups: single seizure (n = 314), incident epilepsy (n = 127), prevalent epilepsy (n = 398) and recurrent acute symptomatic seizures (RASS) (n = 175). The etiologic contribution of NC to each of the subgroups was examined with imaging studies.


RESULTS
Neurocysticercosis was diagnosed on imaging studies in 34.6% of patients with seizure disorder of any type, 59.2% of those with a single seizure, 23.7% of those with recurrent seizure disorder, 92.0% of those with RASS, none of cases of incident epilepsy and 2.0% with prevalent epilepsy. A diagnosis of NC was significantly associated with single seizures (P < 0.001).


CONCLUSIONS
Imaging abnormalities consistent with NC are frequently noted in persons presenting with a single seizure in neurologic care in NC-endemic countries like India. The probability of diagnosing NC diminishes with increasing numbers of seizures. Among samples of individuals with recurrent-unprovoked seizures, it is rare for imaging to demonstrate lesions of NC.
Department of Neurology, Dayanand Medical College, Ludhiana, Punjab, India. gagandee@glide.net.in
G
G
Singh
P
P
Singh
I
I
Singh
A
A
Rani
S
S
Kaushal
G
G
Avasthi
D000293:Adolescent; D000328:Adult; D001921:Brain / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology; D002648:Child; D004827:Epilepsy / Q000145:classification* / Q000453:epidemiology* / Q000469:parasitology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007194:India; D008297:Male; D020019:Neurocysticercosis / Q000150:complications* / Q000175:diagnosis* / Q000503:physiopathology; D015995:Prevalence; D011446:Prospective Studies; D011859:Radiography