Transient cortical blindness as a manifestation of solitary cysticercus granuloma

Hussain, Shabbir; Hussain, Kosar

doi:10.1136/bcr-2012-007552

Cited by 5 publications

(3 citation statements)

References 34 publications

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“…31,32 Although this is theoretically possible-and must occur in a reduced percentage of cases-several pieces of evidence favor a causal relationship between NCC and recurrent nonprovoked seizures. Published evidence include abundant descriptions of cases with focal epilepsies related to the location of a single parasite in the brain parenchyma, [33][34][35][36][37] the higher prevalence of epilepsy in cysticercosis-endemic areas when compared with nonendemic regions, 38 and the occurrence of inflammatory changes surrounding parenchymal brain cysticerci immediately after a seizure in up to 50% cases. 39 In addition, although it has been suggested that some degenerating cysticerci may induce reactive seizures due to transient episodes of inflammation, calcified cysticerci-such as those Figure 2.…”

Section: Discussionmentioning

confidence: 99%

On the relationship between calcified neurocysticercosis and epilepsy in an endemic village: A large‐scale, computed tomography–based population study in rural Ecuador

Brutto

Arroyo²,

Brutto

et al. 2017

Epilepsia

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SUMMARY Objective Using a large-scale population-based study, we aimed to assess prevalence and patterns of presentation of neurocysticercosis (NCC) and its relationship with epilepsy in community-dwellers aged ≥20 years living in Atahualpa (rural Ecuador). Methods In a three-phase epidemiological study, individuals with suspected seizures were identified during a door-to-door survey and an interview (Phase I). Then, neurologists evaluated suspected cases and randomly selected negative persons to estimate epilepsy prevalence (Phase II). In Phase III, all participants were offered non-contrast CT for identifying NCC cases. The independent association between NCC (exposure) and epilepsy (outcome) was assessed by the use of multivariate logistic regression models adjusted for age, sex, level of education and alcohol intake. CT findings were subsequently compared to archived brain MRIs in a sizable subgroup of participants. Results Of 1,604 villagers aged ≥20 years, 1,462 (91%) were enrolled. Forty-one persons with epilepsy (PWE) were identified, for a crude prevalence of epilepsy of 28 per 1,000 population (95% C.I.: 20.7 – 38.2). A head CT was performed in 1,228 (84%) out of 1,462 participants, including 39 of 41 PWE. CT showed lesions consistent with calcified parenchymal brain cysticerci in 118 (9.6%) cases (95% C.I.: 8.1% – 11.4%). No patient had other forms of NCC. Nine of 39 PWE, as opposed to 109 of 1,189 participants without epilepsy, had NCC (23.1% versus 9.2%, p=0.004). This difference persisted in the adjusted logistic regression model (OR: 3.04; 95% C.I.: 1.35 – 6.81; p=0.007). Significance This large CT-based study demonstrates that PWE had three times the odds of having NCC than those without epilepsy, providing robust epidemiological evidence favoring the relationship between NCC and epilepsy.

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Section: Discussionmentioning

confidence: 99%

On the relationship between calcified neurocysticercosis and epilepsy in an endemic village: A large‐scale, computed tomography–based population study in rural Ecuador

Brutto

Arroyo²,

Brutto

et al. 2017

Epilepsia

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“…Several population- [ 3 , 4 ] and clinic-based [ 8 - 10 ] studies have shown that primary headaches are more prevalent in subjects with neurocysticercosis. Neurocysticercosis with occipital lesions can even mimick migraine with visual aura [ 11 - 13 ], which was not the case in our patient.…”

Section: Discussionmentioning

confidence: 65%

Cerebral neurocysticercosis mimicking or comorbid with episodic migraine?

et al. 2014

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BackgroundNeurocysticercosis is a major cause of neurological symptoms in developing countries. We report a case of cerebral neurocysticercosis presenting as episodic migraine without aura, with clinico-radiological correlations and discuss the possible causal influence of neurocysticercosis on the pathomechanisms of migraine.Case presentationWe report a 24 year-old male consulting for a one year history of recurrent headaches. He described bilateral frontal and/or temporal attacks of throbbing headache, moderate to severe in intensity, worsened by head movements and accompanied by nausea, photophobia and phonophobia. Attacks lasted between 12 and 60 hours if untreated. He never had symptoms suggestive of a migraine aura or an epileptic seizure. Headache attacks progressively increased in frequency to up to 5 to 7 severe attacks per month. On taking history, the patient reported having consumed undercooked porcine meat. Physical examination was unremarkable. A brain CT scan showed two contiguous occipital cystic lesions with ring enhancement and surrounding edema suggestive of cerebral neurocysticercosis. On laboratory work-up, blood serology for cysticercal antibodies was positive. Full blood count, erythrocyte sedimentation rate, c - reactive protein level, human immunodeficiency virus serology, liver and hepatic function were all normal. Albendazole (1000 mg/day) and prednisolone (60 mg/day) were prescribed for seven days. The patient was examined again two and six months after the end of his treatment and there was a significant reduction in headache severity and frequency.ConclusionWe propose that in our patient the occipital neurocysticercosis lesions cause migraine without aura-like attacks via inflammation in the surrounding brain parenchyma leading to sensitization of the trigemino-vascular system. We cannot rule out, however, the possibility that our patient has a genetic predisposition for migraine without aura and that the fortuitous association of neurocysticercosis is simply an aggravating factor of his migraine.

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“…2 Transient cortical blindness in a 4-year-old boy with underlying NCC has been described. 3 Being a treatable and preventable entity, it seems prudent to consider NCC in children from endemic regions who present with sudden onset neurological or cognitive disorders including unusual clinical manifestations such as amaurosis fugax. Additionally, neuroimaging is recommended in suspected cases of occipital epilepsies to rule out structural lesions such as NCC.…”

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confidence: 99%