Neurocysticercosis--experience at the teaching hospitals of the University of Cape Town
Thomson, A.J.
South African Medical Journal 83(5): 332-334
1993
ISSN/ISBN: 0256-9574 PMID: 8211427 Document Number: 418921
In the 15 years 1975-1989, 239 patients attending the associated teaching hospitals of the University of Cape Town have been identified retrospectively as having neurocysticercosis. One hundred and twenty-three (51.46%) were children 12 years of age or younger, 14 (5.86%) were adolescents aged 13-19 years, and 102 (42.68%) were adults 20 years of age or older. Two hundred and twelve (88.7%) of these patients were black, almost exclusively Xhosa-speakers originating from the eastern Cape homeland regions of Transkei and Ciskei. Although the clinical features of neurocysticercosis are protean, these patients could be divided into three clinicoradiological groups--a group with seizures, a group with raised intracranial pressure, and an asymptomatic group. One hundred and ninety patients (79.5%) presented with seizures, either alone or in combination with other neurological deficits. Eighty-six patients (36%) presented with features of raised intracranial pressure, due to hydrocephalus in 32 cases, to focal space-demanding lesions in 4 and to multifocal cysticercal encephalitis in 50. Of interest is the significant difference in the abnormality causing the raised intracranial pressure in the children as opposed to the adults--44 children had multifocal cysticercal encephalitis while only 6 had hydrocephalus, and 26 adults had hydrocephalus while only 6 young adults (including 2 adolescents) had multifocal encephalitis. In the other 4 adults the raised intracranial pressure was caused by space-demanding mass lesions. Ten adult patients (4.1%) were 'asymptomatic' and a computed tomography scan for investigation of head injury revealed neurocysticercosis.