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Tropical Neurology - part 9

yếu tố trong 8 % của bệnh nhân mà nguyên nhân được thành lập và tỷ lệ của CT quét hiển thị SSCCCTL ở những bệnh nhân có cơn co giật một phần không có nguyên nhân rõ ràng là 18% 0,7 những bệnh nhân này trình bày với các cơn động kinh một phần hoặc unlocalized. Một số những bệnh nhân này có thể có lịch sử giữ vô cớ nhiều năm trước đó. | Epilepsy in the Tropics 429 Fig. 23.3. Postcontrast cranial CT scan axial section showing multiple ring enhancing lesions in a patient with neurocysticercosis who presented with seizures. 23 Single Small Cerebral Calcific CT Lesion SSCCCTL Small single Fig. 23.4 or multiple cerebral calcific lesions are frequently seen in CT scan of patients with epilepsy in neuocysticercosis endemic areas.7 11 14 22 In a hospital-based study from south India SSCCCTL was putative etiological factor in 8 of patients in whom an etiology was established and the proportion of CT scans showing SSCCCTL in patients with partial seizures with no obvious causation was 18 .7 These patients present with partial or unlocalized seizures. Some of these patients may have given history of unprovoked seizure many years earlier. Breakthrough seizures are also common in patients with these lesions.22 Other CNS Infections Infections of the CNS are significant risk factors for both acute symptomatic seizures and epilepsy. Distinction between provoked and unprovoked seizures can be difficult especially in chronic CNS infections. Toxoplasmosis Toxoplasmosis of the CNS is epidemic in patients with AIDS. Epilepsy is a well-recognized consequence. With increasing incidence of AIDS in tropical countries toxoplasmosis may become a more important cause of epilepsy in the tropics.6 Neurofilariasis Of the four highly pathogenic filarial nematodes Onchocerca volvulus is chiefly responsible for cases of neurofilariasis. Onchocerca volvulus is endemic in tropical and subtropical regions of Africa the Middle East Yemen Mexico Guatemala 430 Tropical Neurology 23 Fig. 23.4. Cranial CT scan showing single small calcific lesion in the right parietal region. Colombia Ecuador Venezuela Surinam and in parts of South India.10 11 Besides causing skin rashes subcutaneous nodules and eye diseases filaria affects the nervous system. Microfilariae of Onchocerca volvulus in heavily infected persons may cause focal brain lesions .