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Recurrent headaches may be caused by cerebral toxoplasmosis

World Journal of Clinical Pediatrics 2014年第3期3卷 59-68页

作者： Joseph Prandota anna gryglas Aleksander Fuglewicz Agata Zesawska-Faleńczyk Barbara Ujma-Czapska Leszek Szenborn Janusz Mierzwa Department of Social Pediatrics Faculty of Health Sciences Wroclaw Medical University 51618 Wroclaw Poland Department of Pediatric Neurology Taddeus Marciniak Specialistic Hospital 50420 Wroclaw Poland Department of Pediatrics and Infectious Diseases Wroclaw Medical University 50345 Wroclaw Poland Department of Neurosurgery Wroclaw Medical University 50420 Wroclaw Poland

AIM: To establish seroprevalence and provide characteristics of Toxoplasma gondii(TG) infection in children with recurrent headaches. METHODS: The study was performed in 178 children aged 7-17 years admitted consecutively to the Department of Pediatric Neurology from November 2009 to July 2011. The children were surveyed with a questionnaire with the help and assistance of their parents and blood samples taken on admission were studied for the presence of specific anti-TG Ig M, Ig G antibodies and Ig G avidity using enzyme immunoassay Platelia Toxo Ig M, Ig G. RESULTS: The study showed that 19 children(8 boys, 11 girls; 8-17 years old, mean age 14.36 years) hadhigh serum anti-TG Ig G antibody levels(range: 32.2 > 240 UI/m L, mean 120.18 UI/m L; positive value for Ig G was ≥ 9 UI/m L). The avidity index(AI) ranged from 0.202 to 0.925(scale: ≥ 0.5 high AI). The results for Ig M antibodies were all negative and the obtained results ranged from 0.113 to 0.25 U/m L(mean = 0.191 IU/m L) and all values below 0.8 IU/m L were considered negative. The most frequent complaints found in the seropositive patients were headaches that affected the frontal(13 children), occipital(4) and parietal areas(5). Headaches usually had a pulsating(in 7 patients) and squeezing(6) character and rarely were piercing, dull or expanding. Interestingly, 8 children did not feel discomfort during the headaches, probably because they did not have sufficiently increased intracranial pressure yet. The headaches usually appeared 1-2 times/mo, lasted for 2-6 h, and had a mean intensity of 5.5 points in a 10 point subjective scale. The comorbidities included epilepsy(5 patients), various infections in 3 children(chronic eustachitis, chronic rhinitis, chronic purulent tonsillitis, streptococcal pharyngitis, meningitis, allergic diseases), disturbances of behavior, deficits of attention, and ocular and motor concentration disorders in 1 child. The electroencephalographic and neuroimaging studies performed

关键词： Recurrent headaches Children Seroprevalence of anti-Toxoplasma gondii IgG antibodies IgG avidity Chronic Toxoplasma gondii infection Cerebral toxoplasmosis

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