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Objectives There is shortage of specialists for the diagnosis of children with epilepsy, especially in resource limited settings. Existing INCLEN (International Clinical Epidemiology Network) instrument was validated for children aged 2–9 years. The current study validated modifications of the same including wider symptomatology and age group. Methods The Modified INCLEN tool was validated by a team of experts by modifying the existing tools (2–9 years) to widen the age range from 1 month to 18 years and include broader symptomatology in a tertiary care teaching hospital of North India between January and June 2015. A qualified medical graduate applied the candidate tool which was followed by gold standard evaluation by a Pediatric Neurologist (both blinded to each other). Results A total of 197 children {128 boys (65%) and 69 girls (35%)}, with a mean age of 72.08 (±50.96) months, completed the study. The sensitivity, specificity, positive and negative predictive value, positive and negative likelihood ratio of the modified epilepsy tool were 91.5% (84.5–96.1), 88.6% (80.0–93.5), 89.7% (81.9–95.3), 90.8% (83.7–95.7), 8 (6.6–9.8) and 0.09 (0.07–0.12) respectively. Significance The new modified diagnostic instruments for epilepsy is simple, structured and valid instruments covering 1month to 18 years for use in resource limited settings with acceptable diagnostic accuracy. All seizure semiologies as well as common seizure mimics like breath-holding spells are included in the tool. It also provides for identification of acute symptomatic and febrile seizures. [ABSTRACT FROM AUTHOR]

Neurocysticercosis, parasitic infestation of the central nervous system by the Taenia solium larvae, is a major public health problem, primarily in the developing countries. Seizures are the primary clinical manifestation which could be acute (secondary to active lesions) or remote symptomatic (due to calcified lesions). Cysticidal therapy is the standard of care for solitary parenchymal active neurocysticerci. However treatment related side effects and tendency to spontaneous resolution raises concern from time to time whether cysticidal therapy is actually required. This is a retrospective case record analysis of two groups of patients with solitary parenchymal neurocysticerci (group A; 171 patients between 2000 and 2004 who did not receive cysticidal therapy, group B; 512 patients between 2008 and 2013 who received cysticidal therapy). Group B had significantly more radiological resolution of lesions whereas group A reported significantly more seizure recurrences on antiepileptics. There was no significant difference in occurrence of calcification in the two groups. Overall patients with calcified lesions had significantly more breakthrough seizures. Well designed prospective studies should be planned in future to understand the mechanism underlying the epileptogenicity of calcified lesions and how they are linked to host and environment factors. [ABSTRACT FROM AUTHOR]