Risk of seizures and neurocysticercosis in household family contacts of children with single enhancing lesions

A small, single enhancing lesion (SEL) is often noted upon computed tomogra phy (CT) in children and young adults with recent focal or generalized seiz ures. A high frequency of seizures has been reported in family members of p ersons with SEL. We studied the prevalence of seizures and cysticercus elec tro-immuno-transfer blot (EITB) based seropositivity among family members, specifically household family contacts of pediatric subjects with a SEL. An attempt was also made to determine the etiology of seizures in household f amily contacts using magnetic resonance imaging (MRI). Information regardin g seizure semiology, personal and food habits and detailed family pedigrees was obtained from 20 consecutive pediatric subjects with a SEL and 51 of t heir household family contacts. EITB sere-assays and stool examinations wer e performed on all participating subjects. MRIs were done on all EITB posit ive household family contacts. A family history of seizures was obtained in six index children (30%) (five household first-degree relatives and two di stant relatives). Seventeen index children (85%) and 13 family contacts (27 %) were EITB positive. A tendency towards clustering of EITB positive cases within individual families was observed. Stool examinations did not reveal Taenia species ova in any of EITB positive subjects. Neuroimaging studies revealed abnormalities consistent with active or inactive neurocysticercosi s in all five household family contacts with history of seizures. Four of t hese five subjects were EITB positive and one was EITB negative. We conclud ed that children with SEL and seizures may have a family history of seizure s. There is a high seropositivity rate in household family contacts of pedi atric subjects with solitary cysticercus granulomas (SCGs). EITB based sero positivity in household family contacts with seizures, strongly predicts a cysticercal etiology for seizures. It may be worthwhile to screen household family contacts of children with SEL for taeniasis-cysticercosis. (C) 2000 Elsevier Science B.V. All rights reserved.