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LETTER TO THE EDITOR |
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| Year : 2017 | Volume
: 12
| Issue : 1 | Page : 112 |
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Hippocampal sclerosis in a child with multiple neurocysticercosis
Roosy Aulakh
Department of Pediatrics, Government Medical College and Hospital, Chandigarh, India
| Date of Web Publication | 4-May-2017 |
Correspondence Address:
Roosy Aulakh
Department of Pediatrics, Government Medical College and Hospital, Sector 32, Chandigarh - 160 030
India
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/jpn.JPN_159_16
How to cite this article:
Aulakh R. Hippocampal sclerosis in a child with multiple neurocysticercosis. J Pediatr Neurosci 2017;12:112 |
Dear Sir,
A 7-year-old female child presented with the complaints of three episodes of the left focal seizures over a span of 16 months. Contrast-enhanced magnetic resonance imaging (MRI) brain with coronal (Panels A and D) and sagittal (Panels B and C) cuts depicted multiple peripheral ring-enhancing lesions seen in bilateral cerebral hemispheres, basal ganglia, thalami, midbrain, and cerebellar hemispheres suggestive of neurocysticercosis (NCC). She was given cysticidal therapy (albendazole for 28 days) under steroid cover and was started on eptoin (6.5 mg/kg/day). She remained seizure free for the next 2 years when a repeat plain MRI brain with axial (Panel E), sagittal (Panels F), and coronal (Panel G) cuts depicted single disc-shaped lesion measuring 7.5 mm in the left temporoparietal region with calcification. Anterior head part of the right hippocampus appeared smaller as compared to the left side suggestive of hippocampal sclerosis (HS). This child has continued to remain seizure free during a follow-up period of 1.5 years despite evident right HS.
Recent observations suggest that NCC might act as an initial precipitating injury causing mesial temporal lobe epilepsy associated with HS through two main pathophysiological mechanisms: inflammation-mediated and electrogenic-mediated.[1],[2] This case wherein follow-up neuroimaging studies have revealed the development of HS 2 years after the diagnosis of NCC lends support to the hypothesis that NCC can be a causative factor in the development of HS and potential mechanism seems to be inflammation-mediated and not recurrent seizures. Another unusual finding, in this case, has been nondevelopment of refractory epilepsy despite the presence of HS. This observation needs confirmation through future studies as it suggests that damage to hippocampus in NCC patients might not render it epileptogenic leading to refractory epilepsy.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
 References | |  |
| 1. | Del Brutto OH, Engel J Jr., Eliashiv DS, García HH. Update on cysticercosis epileptogenesis: The role of the hippocampus. Curr Neurol Neurosci Rep 2016;16:1.  |
| 2. | Bianchin MM, Velasco TR, Wichert-Ana L, Alexandre V Jr., Araujo D Jr., dos Santos AC, et al. Characteristics of mesial temporal lobe epilepsy associated with hippocampal sclerosis plus neurocysticercosis. Epilepsy Res 2014;108:1889-95. |
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Dual/double pathology in neurocysticercosis causing drug resistant epilepsy – Chance association or causal? |
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| Radhika Mhatre, Rajalakshmi Poyuran, Arivazhagan Arimappamagan, Sanjib Sinha, Karthik Kulanthaivelu, Raghavendra Kenchaiah, Asranna Ajay, Ravindranadh M Chowdary, Jitender Saini, Rose Dawn Bharath, Paresh Zanzmera, Raghavendra Seetharam, Nishanth Sadashiva, Rajan Jamuna, Parthasarathy Satishchandra, Bhaskara Rao Malla, Shankar SK, Mahadevan Anita | | Epilepsy Research. 2020; 168: 106472 | | [Pubmed] | [DOI] | |
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