Die tierischen Parasiten des Zentralnervensystems

Henneberg, R.

doi:10.1007/978-3-642-99698-6_4

Cited by 21 publications

(22 citation statements)

References 34 publications

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“…Although a few calcified lesions have been described as grossly chalky white lesions 22 containing little host response and sometimes recognized parasite remnants 16,17,22,23 ; nevertheless, a subset of calcifications appear to be associated with inflammation. Enhancement is frequently seen around some calcifications suggesting the presence of enough inflammation to cause blood brain barrier disruption [5][6][7][8][9] ; the histopathology of calcified lesions is sparse.…”

Section: Discussionmentioning

confidence: 99%

“…Enhancement is frequently seen around some calcifications suggesting the presence of enough inflammation to cause blood brain barrier disruption [5][6][7][8][9] ; the histopathology of calcified lesions is sparse. A few illustrations in texts indicate little on-going inflammation, 16,22,23 which is contrasted with the histological descriptions of the entire calcified lesion surgically removed from 2 patients with episodes of perilesional edema, 11 (Nash and others, in preparation). The calcified lesions showed significant mononuclear inflammatory reaction.…”

Section: Discussionmentioning

confidence: 99%

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Corticosteroid Withdrawal Precipitates Perilesional Edema around Calcified Taenia solium Cysts

Mejia¹,

Nash²

2013

The American Society of Tropical Medicine and Hygiene

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Abstract. Calcified Taenia solium granulomas are the focus of repeated episodes of perilesional edema and seizures in 50% of persons with calcifications, history of seizures, and a positive serology for cysticercosis. The pathophysiology is unclear but recent studies suggest the edema is caused by inflammation. We report two new cases and four other published cases where cessation of corticosteroids appeared to result in recurrence or new appearance of perilesional edema around calcifications. This suggests that perilesional edema is an immune-mediated phenomenon.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Corticosteroid Withdrawal Precipitates Perilesional Edema around Calcified Taenia solium Cysts

Mejia¹,

Nash²

2013

The American Society of Tropical Medicine and Hygiene

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“…1 The clinical manifestations of human NCC have been well known since the late 1800s and early 1900s. 2 Cysticerci in the central nervous system cause an extremely varied array of clinical manifestations due to the many possible presenting combinations of topography, stage, and number of lesions, as well as the presence and degree of the surrounding inflammation. The most common manifestations include seizures, headache, and intracranial hypertension.…”

Section: Introductionmentioning

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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“…This finding is in contrast to the few images and descriptions of calcified lesions in the literature, which are for the most part associated with amorphous calcifications and little or no residual inflammation. 1,2,17,49 Does the calcium in the calcification take part in the pathogenesis of perilesional edema or is it just an easily visualized marker of degenerated cysts? Calcification of granulomas is a risk factor for seizure recurrence; 22,23,50 however, there is little direct evidence to implicate calcium deposits directly.…”

mentioning

confidence: 99%

Edema surrounding calcified intracranial cysticerci: clinical manifestations, natural history, and treatment

Nash

2012

Pathogens and Global Health

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Calcified granulomas are the most common radiological finding in neurocysticercosis (10-20% of endemic populations). A small proportion serves as foci of seizure activity, which results in large numbers of persons with epilepsy. Calcified granulomas are not all the same. Some demonstrate blood-brain barrier dysfunction (magnetic resonance imaging enhancement) most likely due to the presence of inflammation, visualizable scolices, and/or gliosis. About half the patients with a recent history of seizures, positive serology, and only calcified lesions develop perilesional edema at the time of a seizure recurrence. The natural history, treatment, and pathophysiology of this phenomenon are not well studied. Episodes are usually associated with seizures or other neurological manifestations, resolve by 4-6 weeks, sometimes occur repeatedly, and usually involve a subset of the same calcifications. Treatment is supportive. Histopathological examination of one calcification associated with multiple perilesional edema episodes revealed significant inflammation and supports the concept that perilesional edema is inflammatory in nature. This most likely is due to host responses to released or newly recognized parasite antigen and/or upregulation of the host immune response. Immunosuppressive and anti-inflammatory agents may be useful in prevention and/or treatment of this phenomenon.

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Die tierischen Parasiten des Zentralnervensystems

Cited by 21 publications

References 34 publications

Corticosteroid Withdrawal Precipitates Perilesional Edema around Calcified Taenia solium Cysts

Corticosteroid Withdrawal Precipitates Perilesional Edema around Calcified Taenia solium Cysts

Current status and future perspectives on the medical treatment of neurocysticercosis

Edema surrounding calcified intracranial cysticerci: clinical manifestations, natural history, and treatment

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