<p><strong>Aim<br /></strong> To present a unique case of a 22-year-old male patient with symptomatic epilepsy manifestation on a background of neurocysticercosis (NCC). <br /><strong>Methods <br /></strong>An Indian student in Kharkiv, who lived in rural parts in India, presented with sudden episodes of seizure followed by severe headaches. Laboratory analyses and neurological status (MRI) were performed. <br /><strong>Results<br /></strong> Neurological status of the patient revealed nystagmus and difficulty in performing coordination tests. General analysis of blood showed raised eosinophil count to 8%. The MRI showed a few small conglomerating peripherally enhancing thick-walled infective granulomas in left frontal lobe with extensive surrounding oedema in the left fronto-parietal lobe. The patient was treated with albendazol, levipil, methylprednisolone and pantoprazole. Clinical symptoms and subsequent MRI showed improvement. <br /><strong>Conclusion<br /></strong> Neurocysticercosis is often misdiagnosed in the early stages, which leads to adverse outcomes. Although seizures are the most common clinical manifestation, it is a symptom that is not found in majority of the patients. The NCC of adult onset accompanying epileptic seizures is not well studied and a link between the helminthic invasion, epilepsy and psychiatric conditions needs to be established. This disease is potentially eradicable with wellplanned eradication programs targeting all stages of Taenia solium life cycle.</p>
The aim of the study is to identify the peculiarities of local immune reactions in the skin with underlying soft tissues in patients with different variants of the multiple sclerosis’ course. Material and methods: The study included 35 patients, hospitalized in the neurological department of the Communal Nonprofit Enterprise of Kharkiv Regional Council «Regional Clinical Hospital» with the established diagnosis of multiple sclerosis. The patients were divided into three study groups, based on different variants of this pathology’s course. Group 1 included 16 patients with relapsing-remitting type of multiple sclerosis. Group 2 included 11 patients with a secondary-progressive type of multiple sclerosis course. Group 3 included 8 patients with a primary progressive type of multiple sclerosis. Patients of all groups underwent a biopsy of the skin with underlying soft tissues in the lower third of the inner surface of the right lower leg. The comparison group (group 4) was represented by 10 autopsy cases (7 women and 3 men) conducted on the basis of the pathological anatomy department of the Communal Nonprofit Enterprise of Kharkiv Regional Council «Regional Clinical Hospital». There were no signs of the nervous system’s pathology during life in all cases of this group. The cause of death was a dislocation of the brain stem or hematocephaly and the main disease was arteriovenous malformation or congenital aneurysm of the cerebral vessels. The material for the morphological study was skin with underlying soft tissues. Microspecimens stained with histological and immunohistochemical methods were studied, using an Olympus BX-41 microscope. The obtained data were statistically processed, using Statistica 6.0 and Microsoft Excel 2003 programs. Results: Survey microscopy showed that in groups 1-3 in comparison with group 4 immune cell infiltrations were more pronounced in the skin with underlying hypodermis. Significantly larger mean values of the absolute number of CD 3-, CD 20- and CD 68-positive cells were revealed immunohistochemically in groups 1-3 compared with group 4. Thus, it was found in patients with multiple sclerosis the activation of T-cell immunity, B-cell immunity and macrophage system with the development of an immune imbalance between them. Our results allow us to think about the participation of all the above immune cells in the pathogenesis of multiple sclerosis development. The revealed disorders of local immune reactions in the skin with underlying hypodermis in patients with multiple sclerosis are less pronounced in the remitting-recurrent variant of the course of the disease, more pronounced in the secondary-progressing and, especially, primary-progressing variants. Conclusions: In patients with multiple sclerosis in the skin with underlying hypodermis activation of T-cell immunity, B-cell immunity and the macrophage system is observed with the development of an immune imbalance between them, characterized by the prevalence of the absolute number of macrophages among all immune cells. Less pronounced violations of local immune reactions in the skin with underlying hypodermis are noted in remitting-relapsing variant of multiple sclerosis course, more pronounced in a secondary-progressing and, especially, primary-progressing variants.
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