1921
Volume 95, Issue 3
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645

Abstract

Abstract

Solitary cysticercus granuloma is a common neuroimaging abnormality in Indian patients with new-onset epilepsy. Calcific transformation of cysticercus granuloma is frequently associated with seizure recurrence. We evaluated predictors of lesion calcification in patients with solitary cysticercus granuloma and new-onset seizures. One hundred twenty-two patients, with new-onset seizures and a solitary cysticercus granuloma of the brain, were enrolled. All patients were clinically and radiologically evaluated and were treated with antiepileptic drug drugs. No patient received albendazole or corticosteroids. The follow-up period was of 1 year. Follow-up computed tomography was performed after 3 and 6 months. In 68 (54.8%) patients, solitary cysticercus granuloma had transformed into a calcified lesion. On logistic regression analysis, moderate-to-severe edema was a significant factor that predicted calcific transformation of the cysticercus granuloma (odds ratio: 3.325; 95% confidence interval: 1.502–7.362). During 1 year of follow-up, 19 (15.6%) patients experienced seizure recurrence. In 16 patients with seizure recurrence, cysticercus granuloma had transformed in to a calcified lesion. In conclusion, in solitary cysticercus granuloma, calcification of the lesion can be predicted if larger amount of perilesional edema is present. Calcification of the granuloma significantly predicts seizure recurrence.

Loading

Article metrics loading...

The graphs shown below represent data from March 2017
/content/journals/10.4269/ajtmh.16-0070
2016-09-07
2019-05-27
Loading full text...

Full text loading...

/deliver/fulltext/14761645/95/3/623.html?itemId=/content/journals/10.4269/ajtmh.16-0070&mimeType=html&fmt=ahah

References

  1. Burneo JG, Cavazos JE, , 2014. Neurocysticercosis and epilepsy. Epilepsy Curr 14: 2328.[Crossref] [Google Scholar]
  2. Garcia HH, Nash TE, Del Brutto OH, , 2014. Clinical symptoms, diagnosis, and treatment of neurocysticercosis. Lancet Neurol 13: 12021215.[Crossref] [Google Scholar]
  3. Garg RK, Malhotra HS, , 2012. Solitary cysticercus granuloma. Expert Rev Anti Infect Ther 10: 597612.[Crossref] [Google Scholar]
  4. Garg RK, , 2002. Single enhancing computerized tomography-detected lesion in immunocompetent patients. Neurosurg Focus 12: e4.[Crossref] [Google Scholar]
  5. Murthy JM, Yangala R, Srinivas M, , 1998. The syndromic classification of the International League Against Epilepsy: a hospital-based study from south India. Epilepsia 39: 4854.[Crossref] [Google Scholar]
  6. Singhi PD, Baranwal AK, , 2001. Single small enhancing computed tomographic lesions in Indian children—II. Clinical features, pathology, radiology and management. J Trop Pediatr 47: 266270.[Crossref] [Google Scholar]
  7. Escobar A, Palacios E, Rodriguez-Carbajal I, Taveras J, , 1983. The pathology of neurocysticercosis. , eds. Cysticercosis of the Central Nervous System. Chicago, IL: Charles C. Thomas, 2754. [Google Scholar]
  8. Garg RK, Nag D, , 1998. Single enhancing CT lesions in Indian patients with seizures: clinical and radiological evaluation and follow up. J Trop Pediatr 44: 204210.[Crossref] [Google Scholar]
  9. Sethi PK, Kumar BR, Madan VS, Mohan V, , 1985. Appearing and disappearing CT scan abnormalities and seizures. J Neurol Neurosurg Psychiatry 48: 866869.[Crossref] [Google Scholar]
  10. Sethi PP, Wadia RS, Kiyawat DP, Ichaporia NR, Kothari SS, Sangle SA, Wadhwa P, , 1994. Ring or disc enhancing lesions in epilepsy in India. J Trop Med Hyg 97: 347353. [Google Scholar]
  11. Rajshekhar V, , 2001. Rate of spontaneous resolution of a solitary cysticercus granuloma in patients with seizures. Neurology 57: 23152317.[Crossref] [Google Scholar]
  12. Rajshekhar V, Chandy MJ, , 1997. Validation of diagnostic criteria for solitary cerebral cysticercus granuloma in patients presenting with seizures. Acta Neurol Scand 96: 7681.[Crossref] [Google Scholar]
  13. Chernov MF, Kubo O, Hayashi M, Izawa M, Maruyama T, Usukura M, Ono Y, Hori T, Takakura K, , 2005. Proton MRS of the peritumoral brain. J Neurol Sci 228: 137142.[Crossref] [Google Scholar]
  14. Rathore C, Thomas B, Kesavadas C, Abraham M, Radhakrishnan K, , 2013. Calcified neurocysticercosis lesions and antiepileptic drug-resistant epilepsy: a surgically remediable syndrome? Epilepsia 54: 18151822.[Crossref] [Google Scholar]
  15. Nash TE, Bartelt LA, Korpe PS, Lopes B, Houpt ER, , 2014. Calcified neurocysticercus, perilesional edema, and histologic inflammation. Am J Trop Med Hyg 90: 318321.[Crossref] [Google Scholar]
  16. 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]
  17. Nash TE, Mahanty S, Loeb JA, Theodore WH, Friedman A, Sander JW, , 2015. Neurocysticercosis: a natural human model of epileptogenesis. Epilepsia 56: 177183.[Crossref] [Google Scholar]
  18. Gupta RK, Awasthi R, Rathore RK, 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]
  19. Lalla RS, Garg RK, Malhotra HS, Jain A, Verma R, Pandey CM, Singh GP, Sharma PK, , 2015. Cytokines, MMP-2, and MMP-9 levels in patients with a solitary cysticercus granuloma. Neurol India 63: 190196.[Crossref] [Google Scholar]
  20. Restrepo BI, Alvarez JI, Castaño JA, Arias LF, Restrepo M, Trujillo J, Colegial CH, Teale JM, , 2001. Brain granulomas in neurocysticercosis patients are associated with a Th1 and Th2 profile. Infect Immun 69: 45544560.[Crossref] [Google Scholar]
  21. Ooi WW, Wijemanne S, Thomas CB, Quezado M, Brown CR, Nash TE, , 2011. 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]
  22. 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]
  23. Zhao BC, Jiang HY, Ma WY, Jin DD, Li HM, Lu H, , 2016. Albendazole and corticosteroids for the treatment of solitary cysticercus granuloma: a network meta-analysis. PLoS Negl Trop Dis 10: e0004418.[Crossref] [Google Scholar]
http://instance.metastore.ingenta.com/content/journals/10.4269/ajtmh.16-0070
Loading
/content/journals/10.4269/ajtmh.16-0070
Loading

Data & Media loading...

  • Received : 31 Jan 2016
  • Accepted : 14 Jun 2016
  • Published online : 07 Sep 2016

Most Cited This Month

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error