Neurocysticercosis in Nepal: a retrospective clinical analysis

Aim: The prevalence of epilepsy is higher in Nepal. This study was conducted to analyze the clinical manifestations of neurocysticercosis (NCC) among seizure patients admitted to our center.Methods: We retrospectively studied all the NCC patients admitted to Neurology Department, Bir Hospital, Kathmandu, Nepal from April 2012 to February 2014. Computer tomography/ magnetic resonance imaging (CT/MRI) head, clinical profile, lab investigations and exclusion of other causes were the basis of the NCC diagnosis. Chi-square and Student’s t-test were used for comparison of variables.Results: Out of 131 seizure patients admitted, 21 patients were diagnosed with NCC [mean age: 33.95 ± 16.41; male: 15 (71.4%), female: 6 (28.6%)]. Generalized tonic clonic seizure was the most common seizure type in NCC patients (18 patients; 85.7%), two of them had status epilepticus during presentation in Emergency Department. Three patients had focal seizure, one with epilepsia partialis continua. Neuroimaging showed multiple NCC lesions in 8 (38.1%) and a single NCC lesion in 13 (61.9%) patients. Seven of them (33.3%) sought traditional healers before being presented to our center. Eight patients (38.1%) were treated with antiepileptics in local health-post without neuroimaging studies done. Calcified stage of NCC was the most frequent CT/MRI findings (12 patients; 57.1%). Phenytoin was preferred both by physicians and patients due to its low cost.Conclusion: NCC is a common finding among seizure patients in Nepal. Poor economic status, illiteracy and underdeveloped rural society are the major challenges in prevention and treatment of NCCs