Single small enhancing CT lesions in Indian patients with epilepsy: clinical, radiological and pathological considerations.

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

doi:10.1136/jnnp.54.8.702

Cited by 101 publications

(41 citation statements)

References 14 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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“…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.…”

Section: Types Of Nccmentioning

confidence: 99%

Current status and future perspectives on the medical treatment of neurocysticercosis

Gonzáles¹,

Garcı́a

2012

Pathogens and Global Health

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Neurological disease resulting from neurocysticercosis (NCC) is common in most of the world. The variability in the biology of the infection and in its clinical manifestations has led to much confusion regarding appropriate management. Therapeutic options have evolved from surgery, symptomatic measures, and steroids, to include the use of anti-parasitic drugs and minimally invasive neurosurgery. This manuscript reviews the principles of medical therapy for NCC, from discussion of the need for individualized management approaches for each type of NCC to exploration of the most likely potential additions or modifications currently under study.

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“…72 In contrast, single or multiple ringlike or nodular enhancing lesions, as seen in patients with cysticerci in the acute encephalitic phase or in those with cysticercal encephalitis, are nonspecific and represent a diagnostic challenge because pyogenic brain abscesses, fungal abscesses, tuberculomas, toxoplasma abscesses, and brain tumors may produce similar findings on CT or MR imaging. 7,16,50,55 Computerized tomography and MR imaging findings in meningeal cysticercosis include hydrocephalus, abnormal enhancement of the leptomeninges at the skull base, large subarachnoid cysts, and cerebral infarcts. 3,40 In patients with infarcts, cerebral angiography may reveal segmental narrowing or occlusion of major intracranial arteries.…”

Section: Neurosurg Focus / Volume 12 / June 2002mentioning

confidence: 99%

Review of neurocysticercosis

Sotelo¹,

Brutto²

2002

FOC

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In the neurosurgical services in many developing countries, treatment of neurocysticercosis (NCC) accounts for greater than 10% of brain surgical procedures and approximately 15% of neurological consultations. In these areas brain cysticercosis is the leading cause of hydrocephalus in adults and the first cause of late-onset epilepsy. During the last two decades, successful medical treatment has been established. Additionally, neuroimaging and immunological studies have clearly defined the topography, pathophysiological mechanisms, and biological status of these lesions. Thus, selection of cases for medical or surgical treatment has improved; in a significant number of cases, both interventions are required. New therapies with either albendazole or praziquantel have respectively reduced to 8 days and to 1 day the course of anticysticidal therapy, which now is fast, effective, inexpensive, atoxic, and convenient, particularly in endemic areas where most patients belong to the lower socioeconomic groups. Additionally, the rational use of steroid agents facilitates the treatment of inflammation, a conspicuous accompaniment in cases of NCC. A major effort, however, is still required to eradicate this disease.

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Single small enhancing CT lesions in Indian patients with epilepsy: clinical, radiological and pathological considerations.

Cited by 101 publications

References 14 publications

Current Consensus Guidelines for Treatment of Neurocysticercosis

Current Consensus Guidelines for Treatment of Neurocysticercosis

Current status and future perspectives on the medical treatment of neurocysticercosis

Review of neurocysticercosis

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