Neurocysticercosis in Brazilian children: report of 10 cases.

In a 6-year period, ten cases of neurocysticercosis were diagnosed in children with ages ranging from 4 to 13 years, in a Brazilian teaching hospital. Most of the children presented epilepsy and/or raised intracranial pressure, but meningoencephalitis and psychotic reactions were also observed. The cerebrospinal fluid (CSF) cell count ranged from 1 to 52 cells per mm3, with pleocytosis in 6 cases, mostly by lymphocytes and eosinophils. Antibodies to Cysticercus cellulosae were detected in the CSF in all cases. A cranial radiograph was abnormal in 5 out of 6 cases, and a computed tomographic (CT) scan in 4 out of 8 cases. Stool examination was positive for ova and/or proglottids of Taenia sp in 4 out of the 10 cases. Seven patients were treated with either praziquantel or albendazole plus dexamethasone; there were no important side effects, and surgical treatment was required in no case. Neurocysticercosis must be included in the differential diagnosis of seizures, raised intracranial pressure, meningitis and psychotic reactions in children living in or having travelled to the tropics. The diagnosis can be suspected by the presence of eosinophils in the CSF, and confirmed by imaging methods such as CT scans and by immunological tests in the CSF.