Neurocysticercosis - experience at the teaching hospitals of the University of Cape Town

Abstract

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 ofTranskei 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 spacedemanding mass lesions. Ten adult patients (4,1%) were 'asymptomatic' and a computed tomography scan for investigation of head injury revealed neurocysticercosis.

S Afr Med J 1993; 83: 332-334