Cysticercosis Causing Single, Small Ct Lesions in Indian Patients With Seizures

Chandy, Mathew J.; Rajshekhar, Vedantam; Prakash, S K; Ghosh, Siddhartha; Joseph, Thomas; Abraham, Jacob; Chandi, Sushil M.

doi:10.1016/s0140-6736(89)91771-6

Cited by 68 publications

(28 citation statements)

References 2 publications

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“…Among many case series (19,20,34,36,(85)(86)(87)99), only three randomized, controlled trials of albendazole have been reported on patients with single enhancing lesions. Two studies demonstrated no significant difference in radiographic resolution (79,93).…”

Section: Vol 15 2002 Guidelines For Treatment Of Neurocysticercosismentioning

confidence: 99%

“…During the last two decades, the introduction of computed tomography (CT) and later magnetic resonance imaging (MRI) permitted the identification of mild cases with only a few parenchymal cysts, and the terms benign and malign cysticercosis were coined (26,50). Later, studies in India showed that a vast majority of single enhancing lesions, until then attributed to tuberculosis, were in fact degenerating cysticerci (19,20,86,87).…”

Section: Introductionmentioning

confidence: 99%

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Current Consensus Guidelines for Treatment of Neurocysticercosis

et al. 2002

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Taenia solium neurocysticercosis is a common cause of epileptic seizures and other neurological morbidity in most developing countries. It is also an increasingly common diagnosis in industrialized countries because of immigration from areas where it is endemic. Its clinical manifestations are highly variable and depend on the number, stage, and size of the lesions and the host's immune response. In part due to this variability, major discrepancies exist in the treatment of neurocysticercosis. A panel of experts in taeniasis/cysticercosis discussed the evidence on treatment of neurocysticercosis for each clinical presentation, and we present the panel's consensus and areas of disagreement. Overall, four general recommendations were made: (i) individualize therapeutic decisions, including whether to use antiparasitic drugs, based on the number, location, and viability of the parasites within the nervous system; (ii) actively manage growing cysticerci either with antiparasitic drugs or surgical excision; (iii) prioritize the management of intracranial hypertension secondary to neurocysticercosis before considering any other form of therapy; and (iv) manage seizures as done for seizures due to other causes of secondary seizures (remote symptomatic seizures) because they are due to an organic focus that has been present for a long time

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Section: Vol 15 2002 Guidelines For Treatment Of Neurocysticercosismentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Current Consensus Guidelines for Treatment of Neurocysticercosis

et al. 2002

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“…Few authors have attempted to study the differentiation between the two. One among them, Rajshekhae and chandy 5 suggested that cysticerci are usually round in shape, 20mm or smaller in size, with ring enhancement or a visible scolex; cerebral oedema was severe enough to produce a midline shift. On the other hand tuberculomas are usually irregular in shape, solid and greater than 20 mm in size.…”

Section: Methodsmentioning

confidence: 99%

Focal Cerebral Calcification – Is It Dangerous

Banu¹

2017

JMSCR

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“…A major breakthrough in the understanding of these single CT-enhancing lesions came when Chandy, et al, 5 reported obtaining CT-guided stereotactic biopsy samples. Histopathological examination of these brain tissue samples showed cysticercal granuloma in the majority of patients.…”

Section: Neurocysticercal Cystsmentioning

confidence: 99%

Single enhancing computerized tomography–detected lesion in immunocompetent patients

Garg¹

2002

FOC

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Single enhancing computerized tomography (CT)–documented lesions may occur in several infectious and neoplastic diseases of the central nervous system and are the most common radiological abnormality seen in patients with acute-onset seizures in India and many other developing countries. Similar CT-documented lesions have also been reported in the developed world where these lesions are often considered to be caused by neoplasms or tuberculoma. Histopathological studies in India and even in some developed countries revealed that neurocysticercosis (NCC) is the most likely cause of these lesions provided they fulfill a rigid set of clinical and radiological criteria. Single cysticer-cus granuloma measures less than 20 mm in diameter, may be associated with cerebral edema not severe enough to produce midline shift, and occur in patients with seizures, normal neurological status, and no evidence of active systemic disease. When these lesions resolve spontaneously, either disappearing or changing into a calcified nodule, the diagnosis of NCC is very likely. The second most common cause of these CT-detected lesions is tuberculoma; in patients with these lesions similar clinical and neuroimaging features are also present. Few authors believe that in poor and developing countries, where both tuberculosis and NCC are common, it is difficult to differentiate between tuber-culoma and a single cysticercal granuloma. The most interesting feature of these solitary enhancing lesions is their spontaneous disappearance within weeks or months. Some lesions “heal” by becoming calcified. These patients require only antiepileptic therapy, and this medication may be withdrawn safely after the lesion has resolved on CT scanning. In several studies provision of anticysticercal drugs has been attempted, but because of conflicting results, their role in the management of these single lesions is uncertain. Neurosurgeons have a very limited role to play. In very rare situations, if the lesion increases in size and if focal neurological deficits manifest or seizures are uncontrolled, a brain biopsy sample may be required and histopathological evaluation performed to establish the correct diagnosis.

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Cysticercosis Causing Single, Small Ct Lesions in Indian Patients With Seizures

Cited by 68 publications

References 2 publications

Current Consensus Guidelines for Treatment of Neurocysticercosis

Current Consensus Guidelines for Treatment of Neurocysticercosis

Focal Cerebral Calcification – Is It Dangerous

Single enhancing computerized tomography–detected lesion in immunocompetent patients

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