An uncommon cause of seizures in children living in developed countries: neurocysticercosis -a case report

Neurocysticercosis represents an important cause of seizures in children in endemic countries. It is due to the brain involvement by the larval stage of the cestode Taenia solium (cysticerci). This parasite is commonly found in developing countries of Latin America, Asia and sub-Saharan Africa [1-5]. The prevalence of neurocysticercosis in some of these countries exceeds 10% [6]; conversely in Europe the cases of neurocysticercosis are anecdotal, especially caused by migratory flows from endemic zones or international travels. The case reported below describes a rare cause of seizures in a child who lives in a developed country.A 6 year old boy who was born and lived in Cameroon for four years, in a rural area, was admitted to the Emergency Department with seizure lasting more than thirty minutes, not responsive to Diazepam 0.5 mg/Kg e.r. The patient had immigrated to Italy two years previously. No familiarity for seizures or headache. At the age of 1 year the child had experienced an acute and isolated febrile seizure with oculogyration. He had no recent history of traumatic or infective episodes, neither ingestion of drugs or weight loss. When he woke up that morning, he had speaking difficulties, right deviation of the mouth, followed by right head and gaze deviation, right emiclonic convulsion, and loss of consciousness. At admission the child was afebrile, unconscious, with accelerated heart rate and respiratory difficulties. His head was deviated to the right, there was a generalized hypertonia with hyperextension of right arm and flexion of the left arm. The electroencephalogram (EEG) detected a slow mono-polymorphic activity on the left and central electroencephalographic leads. This activity was absent on the right leads. It suggested a post-critical focal cerebral suffering.He was directly admitted to the Intensive Care Unit and he was successfully treated with Phenobarbital (5 mg/Kg i.v.). The magnetic resonance imaging (MRI) of the brain showed two cysti