A Study of Neuropsychiatric Manifestations in Patients of Neurocysticercosis

By Srivastava, Smita; Chadda, Rakesh et al. | Indian Journal of Psychiatry, July-September 2013 | Go to article overview

A Study of Neuropsychiatric Manifestations in Patients of Neurocysticercosis


Srivastava, Smita, Chadda, Rakesh, Bala, Kiran, Majumdar, Pradipta, Indian Journal of Psychiatry


Byline: Smita. Srivastava, Rakesh. Chadda, Kiran. Bala, Pradipta. Majumdar

Background: Neurocysticercosis (NCC) is an endemic parasitic infection of Asia, Africa, Latin America, and central Europe. Neuropsychiatric manifestations of the illness include epilepsy and behavioral disturbances. There is a dearth of systematic studies on psychiatric manifestations of NCC from various Asian counties. The present study assessed the prevalence of various psychiatric disorders in a cohort of patients with NCC attending a neurological service. Materials and Methods: Detailed psychiatric assessment was carried out on 50 patients of NCC with epilepsy and 50 patients of epilepsy without any evidence of NCC. Comprehensive Psychopathological Rating Scale was used to elicit the symptoms. Cognitive functions were assessed using Mini Mental Status Examination. Psychiatric diagnoses were made as per International Classification of Diseases, 10 [sup]th edition (ICD-10). Results: Sixty eight percent of the patients with NCC suffered from a psychiatric disorder, as compared to 44% of those without NCC (P=0.02). Major depression and mixed anxiety depression were the two most common diagnoses. None of the patients was to found to suffer from a psychotic disorder. The most frequent site of brain lesion of NCC was the parietal lobe, followed by frontal lobes and disseminated lesions. Left sided lesions were associated with greater psychiatric morbidity. Focal seizures with or without secondary generalizations were present more frequently in patients with NCC whereas primary generalized seizures were more common in patients with idiopathic epilepsy (P=0.05). Conclusion: Psychiatric manifestations are more common in patients of epilepsy with NCC than those without NCC. The treating clinician need to be vigilant about the phenomenon.

Introduction

Neurocysticercosis (NCC) is a common neuroparasitic infection with a worldwide distribution. The infection is endemic in rural areas of the developing countries of Asia, Africa, Latin America, and central Europe. [sup][1] Prevalence has been found to be mainly related to socioeconomic factors and feeding habits, especially in Asia and Africa. The illness is especially common in areas where pork is consumed such as Sub-Saharan Africa, India, and in most countries of Southeast Asia. [sup][1],[2],[3],[4] NCC is characterized by the deposition of cysticerci in the brain as a result of eating of undercooked pork. It is the most common parasitic disease of the central nervous system (CNS). [sup][1] NCC is reported to be responsible for nearly half of the late onset cases of epilepsy in the endemic areas, [sup][3] and is also associated with psychiatric manifestations. In an earlier study from Venezuela, nearly 18% of patients admitted to a psychiatric hospital tested positive for cysticercosis on Western Blot test. Most of the positive cases suffered from schizophrenia, organic mental illness, mental retardation, or epilepsy. [sup][5]

Clinical presentation of NCC is diverse and perplexing, varying from an asymptomatic form to a "malignant" form. The polymorphous symptomatology seen in NCC is mimicked only by neuro-tuberculosis and neurosyphilis in India and other developing countries, and multiple sclerosis in the Western countries. Psychiatric symptoms are commonly a part of the clinical presentation of an infectious process. Though psychiatric aspects of classic infectious diseases, such as neurosyphilis and newer infectious diseases such as human immunodeficiency virus (HIV) have been well described in literature and are well researched, psychiatric manifestations of NCC have not been investigated to that extent. [sup][6],[7]

Usual presentation of NCC is with focal seizures or raised intracranial pressure due to internal hydrocephalus. [sup][4],[5] Localizing signs are relatively uncommon, though sudden neurological deficits can result from infarcts. Cases of dementia occurring as a complication of NCC have also been described. …

The rest of this article is only available to active members of Questia

Already a member? Log in now.

Notes for this article

Add a new note
If you are trying to select text to create highlights or citations, remember that you must now click or tap on the first word, and then click or tap on the last word.
One moment ...
Default project is now your active project.
Project items
Notes
Cite this article

Cited article

Style
Citations are available only to our active members.
Buy instant access to cite pages or passages in MLA 8, MLA 7, APA and Chicago citation styles.

(Einhorn, 1992, p. 25)

(Einhorn 25)

(Einhorn 25)

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Note: primary sources have slightly different requirements for citation. Please see these guidelines for more information.

Cited article

A Study of Neuropsychiatric Manifestations in Patients of Neurocysticercosis
Settings

Settings

Typeface
Text size Smaller Larger Reset View mode
Search within

Search within this article

Look up

Look up a word

  • Dictionary
  • Thesaurus
Please submit a word or phrase above.
Print this page

Print this page

Why can't I print more than one page at a time?

Help
Full screen
Items saved from this article
  • Highlights & Notes
  • Citations
Some of your highlights are legacy items.

Highlights saved before July 30, 2012 will not be displayed on their respective source pages.

You can easily re-create the highlights by opening the book page or article, selecting the text, and clicking “Highlight.”

matching results for page

    Questia reader help

    How to highlight and cite specific passages

    1. Click or tap the first word you want to select.
    2. Click or tap the last word you want to select, and you’ll see everything in between get selected.
    3. You’ll then get a menu of options like creating a highlight or a citation from that passage of text.

    OK, got it!

    Cited passage

    Style
    Citations are available only to our active members.
    Buy instant access to cite pages or passages in MLA 8, MLA 7, APA and Chicago citation styles.

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn, 1992, p. 25).

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn 25)

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn 25)

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences."1

    1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

    Cited passage

    Thanks for trying Questia!

    Please continue trying out our research tools, but please note, full functionality is available only to our active members.

    Your work will be lost once you leave this Web page.

    Buy instant access to save your work.

    Already a member? Log in now.

    Search by... Author
    Show... All Results Primary Sources Peer-reviewed

    Oops!

    An unknown error has occurred. Please click the button below to reload the page. If the problem persists, please try again in a little while.