Author:
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-
1.
García HH, Gonzalez AE, Rodriguez S, Tsang VC, Pretell EJ, Gonzales I, Gilman RH; Cysticercosis Working Group in Peru, 2010. Neurocysticercosis: unraveling the nature of the single cysticercal granuloma. Neurology 75: 654–658.
-
2.
Garcia HH, Nash TE, Del Brutto OH, 2014. Clinical symptoms, diagnosis, and treatment of neurocysticercosis. Lancet Neurol 13: 1202–1215.
-
3.
Nash T, 2012. Edema surrounding calcified intracranial cysticerci: clinical manifestations, natural history, and treatment. Pathog Glob Health 106: 275–279.
-
4.
Nash TE, Bustos JA, Garcia HH; Cysticercosis Working Group in Perú, 2017. Disease centered around calcified Taenia solium granuloma. Trends Parasitol 33: 65–73.
-
5.
Singhi P, Ray M, Singhi S, Khandelwal N, 2000. Clinical spectrum of 500 children with neurocysticercosis and response to albendazole therapy. J Child Neurol 15: 207–213.
-
6.
Singhi P, Suthar R, Deo B, Malhi P, Khandelwal NK, 2017. Long-term clinical and radiologic outcome in 500 children with parenchymal neurocysticercosis. Pediatr Infect Dis J 36: 549–555.
-
7.
Singhi P, Dayal D, Khandelwal N, 2003. One week versus four weeks of albendazole therapy for neurocysticercosis in children: a randomized, placebo-controlled double blind trial. Pediatr Infect Dis J 22: 268–272.
-
8.
Singhi P, Jain V, Khandelwal N, 2004. Corticosteroids versus albendazole for treatment of single small enhancing computed tomographic lesions in children with neurocysticercosis. J Child Neurol 19: 323–327.
-
9.
Del Brutto OH, Arroyo G, Del Brutto VJ, Zambrano M, Garcia HH, 2017. On the relationship between calcified neurocysticercosis and epilepsy in an endemic village: a large-scale, computed tomography-based population study in rural Ecuador. Epilepsia 58: 1955–1961.
-
10.
Fleury A et al. 2003. High prevalence of calcified silent neurocysticercosis in a rural village of Mexico. Neuroepidemiology 22: 139–145.
-
11.
Prasad KN, Verma A, Srivastava S, Gupta RK, Pandey CM, Paliwal VK, 2011. An epidemiological study of asymptomatic neurocysticercosis in a pig farming community in northern India. Trans R Soc Trop Med Hyg 105: 531–536.
-
12.
Moyano LM et al. Cysticercosis Working Group in Peru, 2016. High prevalence of asymptomatic neurocysticercosis in an endemic rural community in Peru. PLoS Negl Trop Dis 10: e0005130.
-
13.
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: 1099–1105.
-
14.
Leon A, Saito EK, Mehta B, McMurtray AM, 2015. Calcified parenchymal central nervous system cysticercosis and clinical outcomes in epilepsy. Epilepsy Behav 43: 77–80.
-
15.
Nash TE, Patronas NJ, 1999. Edema associated with calcified lesions in neurocysticercosis. Neurology 53: 777–781.
-
16.
Del Brutto OH, Salgado P, Lama J, Del Brutto VJ, Campos X, Zambrano M, Garcia HH, 2015. Calcified neurocysticercosis associates with hippocampal atrophy: a population-based study. Am J Trop Med Hyg 92: 64–68.
-
17.
Nash TE, Ware JM, Mahanty S, 2017. Natural history of patients with perilesional edema around Taenia solium calcified granulomas. J Infect Dis 215: 1141–1147.
-
18.
Del Brutto OH, Issa NP, Salgado P, Del Brutto VJ, Zambrano M, Lama J, Garcia HH, 2017. The association between neurocysticercosis and hippocampal atrophy is related to age. Am J Trop Med Hyg 96: 243–248.
-
19.
Nash TE et al. 2004. Calcific neurocysticercosis and epileptogenesis. Neurology 62: 1934–1938.
-
20.
Poeschl P, Janzen A, Schuierer G, Winkler J, Bogdahn U, Steinbrecher A, 2006. Calcified neurocysticercosis lesions trigger symptomatic inflammation during antiparasitic therapy. Am J Neuroradiol 27: 653–655.
-
21.
Nash TE, Bartelt LA, Korpe PS, Lopes B, Houpt ER, 2014. Calcified neurocysticercus, perilesional edema, and histologic inflammation. Am J Trop Med Hyg 90: 318–321.
-
22.
de Oliveira Taveira M, Morita ME, Yasuda CL, Coan AC, Secolin R, Luiz Cunha da Costa A, Cendes F, 2015. Neurocysticercotic calcifications and hippocampal sclerosis: a case-control study. PLoS One 10: e0131180.
-
23.
Nash TE, Pretell J, Garcia HH, 2001. Calcified cysticerci provoke perilesional edema and seizures. Clin Infect Dis 33: 1649–1653.
-
24.
Del Brutto OH, 2012. Diagnostic criteria for neurocysticercosis, revisited. Pathog Glob Health 106: 299–304.
-
25.
Del Brutto OH, Nash TE, White AC Jr., Rajshekhar V, Wilkins PP, Singh G, Vasquez CM, Salgado P, Gilman RH, Garcia HH, 2017. Revised diagnostic criteria for neurocysticercosis. J Neurol Sci 372: 202–210.
-
26.
Del Brutto OH, 2016. Diagnostic criteria for neurocysticercosis. Ann Neurol 80: 953–954.
-
27.
Singh AK, Garg RK, Rizvi I, Malhotra HS, Kumar N, Gupta RK, 2017. Clinical and neuroimaging predictors of seizure recurrence in solitary calcified neurocysticercosis: a prospective observational study. Epilepsy Res 137: 78–83.
-
28.
Lachuriya G, Garg RK, Jain A, Makhotra HS, Singh AK, Jain B, Kumar N, Verma R, Sharma PK, 2016. Toll-like receptor-4 polymorphisms and serum matrix metalloproteinase-9 in newly diagnosed patients with calcified neurocysticercosis and seizures. Medicine (Baltimore) 95: e3288.
-
29.
Gulati S, Jain P, Sachan D, Chakrabarty B, Kumar A, Pandey RM, Gupta RK, 2014. Seizure and radiological outcomes in children with solitary cysticercous granulomas with and without albendazole therapy: a retrospective case record analysis. Epilepsy Res 108: 1212–1220.
-
30.
Sharma LN, Garg RK, Verma R, Singh MK, Malhotra HS, 2013. Seizure recurrence in patients with solitary cystic granuloma or single parenchymal cerebral calcification: a comparative evaluation. Seizure 22: 840–845.
-
31.
Del Brutto OH et al. 2018. Calcified neurocysticercosis and headache in an endemic village: a case-control study nested to a population-based cohort. Am J Trop Med Hyg 99: 729–734.
-
32.
Moyano LM et al. 2014. Neurocysticercosis as a cause of epilepsy and seizures in two community-based studies in a cysticercosis-endemic region in Peru. PLoS Negl Trop Dis 8: e2692.
-
33.
Del Brutto OH, 2013. Neurocysticercosis in infants and toddlers: report of seven cases and review of published patients. Pediatr Neurol 48: 432–435.
-
34.
Del Brutto OH, 2012. Neurocysticercosis in a 2-year-old boy infected at home. Pathog Glob Health 106: 122–123.
-
35.
Del Brutto OH, Santibanez R, Noboa CA, Aguirre R, Diaz E, Alarcon TA, 1992. Epilepsy due to neurocysticercosis: analysis of 203 patients. Neurology 42: 389–392.
-
36.
Antoniuk SA, Bruck I, Dos Santos LH, Pintarelli VL, Navolkar FB, Brackmann PC Jr., de Morais RL, 2001. Seizures associated with calcifications and edema in neurocysticercosis. Pediatr Neurol 25: 309–311.
-
37.
Park SY, Barkovich AJ, Weintrub PS, 2000. Clinical implications of calcified lesions of neurocysticercosis. Pediatr Infect Dis J 19: 581–583.
-
38.
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: 460–463.
-
39.
Herrick JA et al. 2018. Inflammation is a key risk factor for persistent seizures in neurocysticercosis. Ann Clin Transl Neurol 5: 630–639.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 633 | 393 | 35 |
| Full Text Views | 932 | 13 | 0 |
| PDF Downloads | 261 | 16 | 0 |
An Ambispective Cohort Study to Assess Seizure Recurrences in Children with Calcified Parenchymal Neurocysticercosis
Abhijit Modak
Abhijit Modak
Pediatric Neurology Unit, Department of Pediatrics, Advanced Pediatric Center, Post Graduate Institute of Medical Education & Research (PGIMER), Chandigarh, India;
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Renu Suthar
Renu Suthar
Pediatric Neurology Unit, Department of Pediatrics, Advanced Pediatric Center, Post Graduate Institute of Medical Education & Research (PGIMER), Chandigarh, India;
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Indar Kumar Sharawat
Indar Kumar Sharawat
Pediatric Neurology Unit, Department of Pediatrics, Advanced Pediatric Center, Post Graduate Institute of Medical Education & Research (PGIMER), Chandigarh, India;
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Naveen Sankhyan
Naveen Sankhyan
Pediatric Neurology Unit, Department of Pediatrics, Advanced Pediatric Center, Post Graduate Institute of Medical Education & Research (PGIMER), Chandigarh, India;
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Jitendra Kumar Sahu
Jitendra Kumar Sahu
Pediatric Neurology Unit, Department of Pediatrics, Advanced Pediatric Center, Post Graduate Institute of Medical Education & Research (PGIMER), Chandigarh, India;
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Prahbhjot Malhi
Prahbhjot Malhi
Pediatric Neurology Unit, Department of Pediatrics, Advanced Pediatric Center, Post Graduate Institute of Medical Education & Research (PGIMER), Chandigarh, India;
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Niranjan Khandelwal
Niranjan Khandelwal
Department of Radiodiagnosis and Imaging, PGIMER, Chandigarh, India
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Calcified neurocysticercosis (NCC), previously thought to be a dead end, is an important risk factor for seizure recurrences. We studied the pattern of seizure recurrences and associated radiological findings in children with calcified NCC. In this ambispective cohort study, we enrolled children (age 1–15 years) with calcified NCC attending the pediatric NCC clinic between January 2017 and December 2017. Retrospective data were collected from the hospital records, and all enrolled children were prospectively followed up till June 2018. The study group divided into two groups: 1) children first presenting with calcified granuloma and 2) children presented with ring-enhancing lesion (REL) and transformed into the calcified lesion during follow-up imaging. During the study period (January 2017–December 2017), 520 children with NCC were screened and 128 with calcified NCC were enrolled. The mean age was 10.8 ± 3.2 years, and 63% were boys. Among 128 children, 40 (31%) had calcified granuloma and 88 (69%) had REL transformed to calcified granuloma. Sixty-one (49%) children had seizure recurrence: 22 (58%) within calcified granuloma group and 39 (45%) within REL transformed to calcified granuloma group (P = 0.18). Seizure recurrence was associated with the presence of perilesional edema (PE) in 35 (57.4%) children on computed tomography scan. The median interval between two seizure recurrences was 30 (17–56) months, and the median antiepileptic drug-free interval was 17 (12–22) months. The total duration of continued seizures was 42 (26–58) months, slightly longer in children with REL transformed to calcified granuloma group (42, 95% CI: 18–66 months) in comparison to calcified granuloma group (35, 95% CI: 10–60 months, P = 0.32). To conclude, children with calcified NCC have seizure recurrences over a prolonged period. Seizure recurrences are intermittent and may be interspersed with a prolonged period of quiescence in between. The presence of PE and contrast enhancement around the lesion during seizure recurrence suggests lesion reactivation.
Author Notes
Authors’ addresses: Abhijit Modak, Renu Suthar, Indar Kumar Sharawat, Naveen Sankhyan, and Jitendra Kumar Sahu, Pediatric Neurology Unit, Department of Pediatrics, Advanced Pediatric Center, PGIMER, Chandigarh, India, E-mails: medabhijit@gmail.com, drrenusuthar@gmail.com, sherawatdrindar@gmail.com, drnsankhyan@yahoo.co.in, and jsh2003@gmail.com. Prahbhjot Malhi, Child Psychology Unit, Department of Pediatrics, Advanced Pediatric Center, PGIMER, Chandigarh, India, E-mail: pmalhi18@hotmail.com. Niranjan Khandelwal, Department of Radiodiagnosis and Imaging, PGIMER, Chandigarh, India, E-mail: khandelwaln@hotmail.com.
ProCite
RefWorks
Reference Manager
BibTeX
Zotero
EndNote
-
1.
García HH, Gonzalez AE, Rodriguez S, Tsang VC, Pretell EJ, Gonzales I, Gilman RH; Cysticercosis Working Group in Peru, 2010. Neurocysticercosis: unraveling the nature of the single cysticercal granuloma. Neurology 75: 654–658.
-
2.
Garcia HH, Nash TE, Del Brutto OH, 2014. Clinical symptoms, diagnosis, and treatment of neurocysticercosis. Lancet Neurol 13: 1202–1215.
-
3.
Nash T, 2012. Edema surrounding calcified intracranial cysticerci: clinical manifestations, natural history, and treatment. Pathog Glob Health 106: 275–279.
-
4.
Nash TE, Bustos JA, Garcia HH; Cysticercosis Working Group in Perú, 2017. Disease centered around calcified Taenia solium granuloma. Trends Parasitol 33: 65–73.
-
5.
Singhi P, Ray M, Singhi S, Khandelwal N, 2000. Clinical spectrum of 500 children with neurocysticercosis and response to albendazole therapy. J Child Neurol 15: 207–213.
-
6.
Singhi P, Suthar R, Deo B, Malhi P, Khandelwal NK, 2017. Long-term clinical and radiologic outcome in 500 children with parenchymal neurocysticercosis. Pediatr Infect Dis J 36: 549–555.
-
7.
Singhi P, Dayal D, Khandelwal N, 2003. One week versus four weeks of albendazole therapy for neurocysticercosis in children: a randomized, placebo-controlled double blind trial. Pediatr Infect Dis J 22: 268–272.
-
8.
Singhi P, Jain V, Khandelwal N, 2004. Corticosteroids versus albendazole for treatment of single small enhancing computed tomographic lesions in children with neurocysticercosis. J Child Neurol 19: 323–327.
-
9.
Del Brutto OH, Arroyo G, Del Brutto VJ, Zambrano M, Garcia HH, 2017. On the relationship between calcified neurocysticercosis and epilepsy in an endemic village: a large-scale, computed tomography-based population study in rural Ecuador. Epilepsia 58: 1955–1961.
-
10.
Fleury A et al. 2003. High prevalence of calcified silent neurocysticercosis in a rural village of Mexico. Neuroepidemiology 22: 139–145.
-
11.
Prasad KN, Verma A, Srivastava S, Gupta RK, Pandey CM, Paliwal VK, 2011. An epidemiological study of asymptomatic neurocysticercosis in a pig farming community in northern India. Trans R Soc Trop Med Hyg 105: 531–536.
-
12.
Moyano LM et al. Cysticercosis Working Group in Peru, 2016. High prevalence of asymptomatic neurocysticercosis in an endemic rural community in Peru. PLoS Negl Trop Dis 10: e0005130.
-
13.
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: 1099–1105.
-
14.
Leon A, Saito EK, Mehta B, McMurtray AM, 2015. Calcified parenchymal central nervous system cysticercosis and clinical outcomes in epilepsy. Epilepsy Behav 43: 77–80.
-
15.
Nash TE, Patronas NJ, 1999. Edema associated with calcified lesions in neurocysticercosis. Neurology 53: 777–781.
-
16.
Del Brutto OH, Salgado P, Lama J, Del Brutto VJ, Campos X, Zambrano M, Garcia HH, 2015. Calcified neurocysticercosis associates with hippocampal atrophy: a population-based study. Am J Trop Med Hyg 92: 64–68.
-
17.
Nash TE, Ware JM, Mahanty S, 2017. Natural history of patients with perilesional edema around Taenia solium calcified granulomas. J Infect Dis 215: 1141–1147.
-
18.
Del Brutto OH, Issa NP, Salgado P, Del Brutto VJ, Zambrano M, Lama J, Garcia HH, 2017. The association between neurocysticercosis and hippocampal atrophy is related to age. Am J Trop Med Hyg 96: 243–248.
-
19.
Nash TE et al. 2004. Calcific neurocysticercosis and epileptogenesis. Neurology 62: 1934–1938.
-
20.
Poeschl P, Janzen A, Schuierer G, Winkler J, Bogdahn U, Steinbrecher A, 2006. Calcified neurocysticercosis lesions trigger symptomatic inflammation during antiparasitic therapy. Am J Neuroradiol 27: 653–655.
-
21.
Nash TE, Bartelt LA, Korpe PS, Lopes B, Houpt ER, 2014. Calcified neurocysticercus, perilesional edema, and histologic inflammation. Am J Trop Med Hyg 90: 318–321.
-
22.
de Oliveira Taveira M, Morita ME, Yasuda CL, Coan AC, Secolin R, Luiz Cunha da Costa A, Cendes F, 2015. Neurocysticercotic calcifications and hippocampal sclerosis: a case-control study. PLoS One 10: e0131180.
-
23.
Nash TE, Pretell J, Garcia HH, 2001. Calcified cysticerci provoke perilesional edema and seizures. Clin Infect Dis 33: 1649–1653.
-
24.
Del Brutto OH, 2012. Diagnostic criteria for neurocysticercosis, revisited. Pathog Glob Health 106: 299–304.
-
25.
Del Brutto OH, Nash TE, White AC Jr., Rajshekhar V, Wilkins PP, Singh G, Vasquez CM, Salgado P, Gilman RH, Garcia HH, 2017. Revised diagnostic criteria for neurocysticercosis. J Neurol Sci 372: 202–210.
-
26.
Del Brutto OH, 2016. Diagnostic criteria for neurocysticercosis. Ann Neurol 80: 953–954.
-
27.
Singh AK, Garg RK, Rizvi I, Malhotra HS, Kumar N, Gupta RK, 2017. Clinical and neuroimaging predictors of seizure recurrence in solitary calcified neurocysticercosis: a prospective observational study. Epilepsy Res 137: 78–83.
-
28.
Lachuriya G, Garg RK, Jain A, Makhotra HS, Singh AK, Jain B, Kumar N, Verma R, Sharma PK, 2016. Toll-like receptor-4 polymorphisms and serum matrix metalloproteinase-9 in newly diagnosed patients with calcified neurocysticercosis and seizures. Medicine (Baltimore) 95: e3288.
-
29.
Gulati S, Jain P, Sachan D, Chakrabarty B, Kumar A, Pandey RM, Gupta RK, 2014. Seizure and radiological outcomes in children with solitary cysticercous granulomas with and without albendazole therapy: a retrospective case record analysis. Epilepsy Res 108: 1212–1220.
-
30.
Sharma LN, Garg RK, Verma R, Singh MK, Malhotra HS, 2013. Seizure recurrence in patients with solitary cystic granuloma or single parenchymal cerebral calcification: a comparative evaluation. Seizure 22: 840–845.
-
31.
Del Brutto OH et al. 2018. Calcified neurocysticercosis and headache in an endemic village: a case-control study nested to a population-based cohort. Am J Trop Med Hyg 99: 729–734.
-
32.
Moyano LM et al. 2014. Neurocysticercosis as a cause of epilepsy and seizures in two community-based studies in a cysticercosis-endemic region in Peru. PLoS Negl Trop Dis 8: e2692.
-
33.
Del Brutto OH, 2013. Neurocysticercosis in infants and toddlers: report of seven cases and review of published patients. Pediatr Neurol 48: 432–435.
-
34.
Del Brutto OH, 2012. Neurocysticercosis in a 2-year-old boy infected at home. Pathog Glob Health 106: 122–123.
-
35.
Del Brutto OH, Santibanez R, Noboa CA, Aguirre R, Diaz E, Alarcon TA, 1992. Epilepsy due to neurocysticercosis: analysis of 203 patients. Neurology 42: 389–392.
-
36.
Antoniuk SA, Bruck I, Dos Santos LH, Pintarelli VL, Navolkar FB, Brackmann PC Jr., de Morais RL, 2001. Seizures associated with calcifications and edema in neurocysticercosis. Pediatr Neurol 25: 309–311.
-
37.
Park SY, Barkovich AJ, Weintrub PS, 2000. Clinical implications of calcified lesions of neurocysticercosis. Pediatr Infect Dis J 19: 581–583.
-
38.
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: 460–463.
-
39.
Herrick JA et al. 2018. Inflammation is a key risk factor for persistent seizures in neurocysticercosis. Ann Clin Transl Neurol 5: 630–639.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 633 | 393 | 35 |
| Full Text Views | 932 | 13 | 0 |
| PDF Downloads | 261 | 16 | 0 |