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Neurocysticercosis: An uncommon cause of drug‐refractory epilepsy in North Indian population
Author(s) -
Goyal Manoj,
Chand Partap,
Modi Manish,
Khandelwal Niranjan,
Kharbanda Parampreet Singh,
Lal Vivek,
Singla Veenu,
Sehgal Rakesh
Publication year - 2015
Publication title -
epilepsia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.687
H-Index - 191
eISSN - 1528-1167
pISSN - 0013-9580
DOI - 10.1111/epi.13130
Subject(s) - neurocysticercosis , medicine , epilepsy , refractory (planetary science) , pediatrics , population , drug resistant epilepsy , retrospective cohort study , psychiatry , physics , environmental health , astrobiology
Summary Objective Being a common cause of epilepsy in endemic areas, neurocysticercosis ( NCC ) is expected to account for a sizable proportion of patients with drug‐refractory epilepsy ( DRE ) as well. However, data regarding prevalence of DRE in NCC are sparse. This study aimed to determine the prevalence of DRE as well as identification of clinical and radiologic factors that lead to DRE in patients with NCC . Methods This study was conducted in a tertiary‐care postgraduate teaching institute in Northern India from July 2011 to July 2013. Two hundred patients with epilepsy due to NCC (definite [n = 59, 29.5%] or probable [n = 141, 70.5%]) based on diagnostic criteria by Del Brutto et al. were enrolled in the study in both a prospective (n = 51 [25.5%]) and a retrospective manner (n = 149 [74.5%]), and were followed for a minimum period of 1 year. Results Thirteen patients with NCC were found to be refractory to drug therapy. Prevalence of DRE was found to be 65 of 1,000 NCC patients with epilepsy in the present study. The risk factors associated with high risk of DRE were male sex (p = 0.035), older age (p = 0.016), pig‐raising practices (p = 0.003), pork eating (p = 0.04), and presence of multiple (>2) (p = 0.0001) or mixed stage lesions (p = 0.007) on neuroimaging. On multivariate analysis, it was found that residing in an area where pig raising is prevalent (p = 0.01) and presence of multiple (>2) (p = 0.004) lesions on neuroimaging are associated with increased risk of DRE . Significance NCC is only rarely associated with the development of DRE . The common risk factors associated with increased chance of DRE include pig‐rearing practices and presence of multiple (>2) lesions on neuroimaging.