Short Course of Prednisolone in Indian Patients with Solitary Cysticercus Granuloma and New‐onset Seizures

Abstract

Summary:Purpose: To evaluate the role of a short course of oral corticosteroids in Indian patients with solitary cysticercus granuloma with seizures. Methods:In this open-label, randomized, prospective followup study, 97 patients with new-onset seizures and a single enhancing computed tomography (CT)-detected lesion of cysticercosis were randomly divided in two groups to receive either antiepileptic monotherapy alone (n = 48) or antiepileptic monotherapy with prednisolone (n = 49). The patients in the latter group received prednisolone, 1 mg/kg/day for 10 days, followed by tapering over next 4 days. The patients were followed up for 6 months. Repeated CT scans were performed after 1 and 6 months.Results: The majority of patients were young. Simple partial seizure, with or without secondary generalization, was the commonest seizure type encountered. Follow-up CT scans at 1 and 6 months demonstrated a significantly better response for prednisolone as far as complete resolution of CT lesion was concerned. Kaplan-Meier analysis suggested significantly less probability of seizure recurrence for prednisolonetreated patients. At 6 months, Kaplan-Meier estimated risk of seizure after first seizure was 2% in prednisolone-treated patients in comparison to 13% for those who were not given prednisolone.Conclusions: Short-term prednisolone therapy helps in rapid resolution of solitary cysticercus granuloma in Indian patients with new-onset seizures. Resolution of lesions is associated with improved seizure-related prognosis.

Short course of prednisolone in patients with solitary cysticercus granuloma: A double blind placebo controlled study

“…The lesion was considered 'partially resolved' if, on visual analysis, there was a substantial reduction in the amount of perilesional oedema and size of the lesion. 3 The statistical analysis was done by using chisquare test for categorical observations. Student's t test to compare continuous observations such as age, onset, number of seizures, and duration of illness between two groups.…”

“…Short-term prednisolone therapy helps in rapid resolution of solitary cysticercus granuloma in Indian patients with new-onset seizures. 3 The present study was planned to confirm the role of a short course of oral corticosteroids in patients with solitary cysticercus granuloma by a double-blind placebo-controlled study.…”

Epilepsy and Neurocysticercosis in Sub-Saharan Africa

“…Treatment regimens consisted of prednisolone 1 mg/kg for 10 days with a 4-day taper with and without antiepileptic treatment, prednisolone 1 mg/kg for 7 days with a 3-day taper without antiepileptic treatment and methylprednisolone 1 g/1.72 m 2 for 5 days without antiepileptic treatment. All studies showed a decrease in epileptic seizures and three showed a significant clearance of cysts on CT [122][123][124][125].…”

Current status and future perspectives on the medical treatment of neurocysticercosis

“…2). [11][12][13][14] Patients with massive infections, conversely, carry poorer prognosis. If a lesion resolves but leaves a calcified scar, the prognosis for seizure relapse is poorer.…”