Volume 89, Issue 5
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645



Calcified granulomas are the focus of repeated episodes of perilesional edema and seizures in 50% of persons with calcifications, history of seizures, and a positive serology for cysticercosis. The pathophysiology is unclear but recent studies suggest the edema is caused by inflammation. We report two new cases and four other published cases where cessation of corticosteroids appeared to result in recurrence or new appearance of perilesional edema around calcifications. This suggests that perilesional edema is an immune-mediated phenomenon.


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  1. Ndimubanzi PC, Carabin H, Budke CM, Nguyen H, Qian YJ, Rainwater E, Dickey M, Reynolds S, Stoner JA, , 2010. A systematic review of the frequency of neurocyticercosis with a focus on people with epilepsy. PLoS Negl Trop Dis 4: e870.[Crossref] [Google Scholar]
  2. Nash TE, Garcia HH, , 2011. Diagnosis and treatment of neurocysticercosis. Nat Rev Nephrol 7: 584594.[Crossref] [Google Scholar]
  3. Nash TE, Pretell EJ, Lescano AG, Bustos JA, Gilman RH, Gonzalez AE, Garcia HH, Cysticercosis Working Group in Peru; , 2008. Perilesional brain oedema and seizure activity in patients with calcified neurocysticercosis: a prospective cohort and nested case-control study. Lancet Neurol 7: 10991105.[Crossref] [Google Scholar]
  4. Nash TE, Del Brutto OH, Butman JA, Corona T, Delgado-Escueta A, Duron RM, Evans CA, Gilman RH, Gonzalez AE, Loeb JA, Medina MT, Pietsch-Escueta S, Pretell EJ, Takayanagui OM, Theodore W, Tsang VC, Garcia HH, , 2004. Calcific neurocysticercosis and epileptogenesis. Neurology 62: 19341938.[Crossref] [Google Scholar]
  5. Nash TE, Pretell J, Garcia HH, , 2001. Calcified cysticerci provoke perilesional edema and seizures. Clin Infect Dis 33: 16491653.[Crossref] [Google Scholar]
  6. Gupta RK, Awasthi R, Rathore RKS, Verma A, Sahoo P, Paliwal VK, Prasad KN, Pandey CM, Narayana PA, , 2012. Understanding epileptogenesis in calcified neurocysticercosis with perfusion MRI. Neurology 78: 618625.[Crossref] [Google Scholar]
  7. Sheth TN, Pillon L, Keystone J, Kucharczyk W, , 1998. Persistent MR contrast enhancement of calcified neurocysticercosis lesions. AJNR Am J Neuroradiol 19: 7982. [Google Scholar]
  8. White AC, Jr, 1997. Neurocysticercosis: a major cause of neurological disease worldwide. Clin Infect Dis 24: 101113.[Crossref] [Google Scholar]
  9. Del Brutto OH, , 1994. Prognostic factors for seizure recurrence after withdrawal of antiepileptic drugs in patients with neurocysticercosis. Neurology 44: 17061709.[Crossref] [Google Scholar]
  10. Nash T, , 2012. Edema surrounding calcified intracranial cysticerci: clinical manifestations, natural history, and treatment. Pathogens and Global Health 106: 275279.[Crossref] [Google Scholar]
  11. Ooi WW, Wijemanne S, Thomas CB, Quezado M, Brown CR, Nash TE, , 2011. Short report: a calcified Taenia solium granuloma associated with recurrent perilesional edema causing refractory seizures: histopathological features. Am J Trop Med Hyg 85: 460463.[Crossref] [Google Scholar]
  12. Sheth TN, Lee C, Kucharczyk W, Keystone J, , 1999. Reactivation of neurocysticercosis: case report. Am J Trop Med Hyg 60: 664667. [Google Scholar]
  13. Park SY, Barkovich AJ, Weintraub PS, , 2000. Clinical implications of calcified lesions of neurocysticercosis. Pediatr Infect Dis J 19: 581583.[Crossref] [Google Scholar]
  14. Mitre E, Talaat KR, Sperling MR, Nash TE, , 2007. Methotrexate as a corticosteroid-sparing agent in complicated neurocysticercosis. Clin Infect Dis 44: 549553.[Crossref] [Google Scholar]
  15. Poeschl P, Janzen A, Schuierer G, Winkler J, Bogdahn U, Steinbrecher A, , 2006. Calcified neurocysticercosis lesions trigger symptomatic inflammation during antiparasitic therapy. AJNR Am J Neuroradiol 27: 653655. [Google Scholar]
  16. Escobar A, Palacios E, Rodriguez-Carbajal J, Taveras JM, , 1983. Pathology of the nervous system. , editors. Cysticercosis of the Central Nervous System. Springfield, IL, Charles Thomas, 2754. [Google Scholar]
  17. Escobar A, Weidenheim K, Singh G, Prabhakar S, , 2002. The pathology of neurocysticercosis. , editors. Taenia solium Cysticercosis: From Basics to Clinical Science. Wallingford, Oxon, UK: CABI Publishing, 289305.[Crossref] [Google Scholar]
  18. Masahiro F, Mahanty S, Zoghbi S, Araneta M, Hong J, Pike V, Innis RB, Nash TE, , 2013. PET reveals inflammation around calcified Taenia solium granulomas with perilesional edema. PLoS ONE 8: e74052.[Crossref] [Google Scholar]
  19. Milligan TA, Zamani A, Bromfield E, , 2009. Frequency and patterns of MRI abnormalities due to status epilepticus. Seizure 18: 104108.[Crossref] [Google Scholar]
  20. Raghavendra S, Ashalatha R, Krishnamoorthy T, Kesavadas C, Thomas SV, Radhakrishnan K, , 2007. Reversible periictal MRI abnormalities: clinical correlates and long-term outcome in 12 patients. Epilepsy Res 73: 129136.[Crossref] [Google Scholar]
  21. Cole AJ, , 2004. Status epilepticus and periictal imaging. Epilepsia 45 (Suppl 4): 7277.[Crossref] [Google Scholar]
  22. Henneberg R, Lewandowsky M, , 1912. Die tierischen Parasiten des Zentralnervensystems. , editor. Handbuch der Neurologie. 642683. [Google Scholar]
  23. Marquez-Monter H, Marcial-Rojas R, , 1971. Cysticercosis. , editor. Pathology of Protozoal and Helminthic Diseases. Baltimore, MD: Williams & Wilkins Company, 592617. [Google Scholar]
  24. Nash TE, Patronas NJ, , 1999. Edema associated with calcified lesions in neurocysticercosis. Neurology 53: 777781.[Crossref] [Google Scholar]

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  • Received : 12 Jun 2013
  • Accepted : 31 Jul 2013
  • Published online : 06 Nov 2013

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