The clinical profile ofring-enhancing lesions among children below 12 years presenting with epileptic and non-epileptic manifestations in a tertiary care hospital

Abstract

Background:Single ring-enhancing computed tomography lesions are commonly seen in young patients presenting with acute symptomatic seizures. It has also been observed in many varieties of non-epileptic manifestations. The present study was conducted to evaluate the clinical profile and incidence of ring-enhancing lesions in contrast-enhanced computerizedtomography (CECT) scan in children presenting with seizures focal neurological deficits and other non-seizure CNS manifestations.Methods:  A cross-sectional study was conducted on48 children in the age group of   0 to 12 years with a history of seizures (GTCS, simple partial (SP), complex partial (CP), and simple partial with secondary generalization (S. P+S.G)), focal neurological deficits and other non-seizure CNS manifestations. Detailed clinical examinationalong with of Neurocysticercosis (NCC) and tuberculoma diagnosis were made using CECT scan. IBM SPSS version 22 was used for statistical analysis. Results: Majority of the children were above 5 years of age (79.16%) and presented with single lesion (77.08%). Majority were diagnosed with 30 (62.50%) NCC, followed by tuberculoma 6 (12.50%), and 12 (25%) had unknown aetiology. Seizures alone were observed in 38 (79.16%) cases, 9 (18.74%) had seizures and non-epileptic manifestations like episodic headache, focal deficit and raised intracranial tension. All the tuberculoma patients had decreased edema on follow-up andmost of the NCC cases (32.14%) had calcifications.Conclusion: NCC is the most common non-seizure CNS manifestations presenting with a single ring-enhancing CT lesion among children. Differentiating between all these ring-enhancing lesions is essential as misdiagnoses can cause grave danger to life.

Keywords: NCC, Tuberculoma, Seizures, Ring enhancing lesions, CECT