Disappearing CT lesions in epilepsy: is tuberculosis or cysticercosis the cause?

Gk, Ahuja; Behari, M; Prasad, Kishore Chandra; Goulatia, R. K.; Jailkhani, B. L.

doi:10.1136/jnnp.52.7.915

Cited by 40 publications

(12 citation statements)

References 9 publications

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“…5). The duration or time of resolution of the lesion seems to be quite variable, from a few weeks to >I year (29,75,134,135,145,147), which leads us to think that the main etiology of SIL is NC.…”

Section: Single Inflammatory Lesion and Seizuresmentioning

confidence: 99%

Cysticercosis and Epilepsy: A Critical Review

1998

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Summary: Neurocysticercosis (NC) remains a major public health problem in developing and some developed countries. Currently, the best procedures for diagnosing NC are neuroimaging studies. Immunoserologic assays, such as enzyme-linked immunoelectrotransfer blot assay (EITB) or enzyme-linked immunosorbent assay (ELISA), detect antibodies against Taenia solium, or cysticercus. Consequently, they are useful in identifying a population at risk of contact with the parasite but do not necessarily indicate a systemic active infection. Most seropositive individuals are asymptomatic. No data from prospective studies concern the proportion of these individuals that will develop seizures or other neurologic symptoms. There is a discrepancy between the results of serologic assays and neuroimaging studies: >SO% of those individuals with NC diagnosed by computed tomography (CT) scan test EITB negative.Pathophysiologic classification of NC into active, transitional, and inactive forms permits a good correlation between clinical manifestations and neuroimaging procedures and facilitates medical and surgical management and research. The most frequent clinical manifestations of NC are seizures. We assume that NC is the main cause of symptomatic epilepsy in developing countries; however, no case-control or cohort studies demonstrate this association. Most patients with NC with seizures have a good prognosis; nevertheless, further studies analyzing factors related to recurrence of seizures and possibilities of discontinuation of antiepileptic medications (AEDs) are needed.Regarding treatment of NC with antihelminthic drugs, no controlled clinical trials exist that establish specific indications, definitive doses, and duration of treatment. The most effective approach to taeniasis/cysticercosis infection is prevention. This should be a primary public health focus for developing countries.We critically review the available information regarding the epidemiology and diagnosis of human cysticercosis, the physiopathology and imaging correlation of the parasite in the central nervous system (CNS) of the host, the relation between seizures or epilepsy and NC, and the issues surrounding the treatment and prognosis of NC, including the use of antihelminthic therapy.

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Section: Single Inflammatory Lesion and Seizuresmentioning

confidence: 99%

Cysticercosis and Epilepsy: A Critical Review

1998

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“…In view of the frequent spontaneous disappearance of CT lesions, some authors do not recommend the use of cysticidal agents in the management of SSECTLs. [12][13][14] However, studies in both adults and children with SSECTLs have demonstrated the benefits of albendazole administration, both in terms of seizure control and resolution of the granuloma on follow-up imaging studies. [5,7,15] The exact duration of albendazole therapy remains unclear.…”

Section: Introductionmentioning

confidence: 96%

“…[1] Sociocultural aspects of epilepsy have effect on the depression. [8][9][10][11] Nondisclosure or concealment and non-adherence to drug treatment may result in marital disharmony and disrupted family life [9,12,13] and depression may be the consequence of these factors or these factors may contribute to the onset of depression. [2,8] In addition, societal stigma and the myth that epilepsy is contagious are contributing factors for depression, especially following retrenchment at work or disruption of academic work.…”

Section: Introductionmentioning

confidence: 99%

Comparison of 1 week versus 4 weeks of albendazole therapy in single small enhancing computed tomography lesion

et al. 2010

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“…Several reports exist in the literature on 'disappearing CT lesions' [1][2][3][4][5][6]. Various explanations have been put forward, pointing to the inflammatory, infective or immunological etiology [1,4] of many of these lesions. We are unaware of any record of sponta neous disappearance of a histologically proven CNS tu mor.…”

Section: Introductionmentioning

confidence: 99%

“…The common experience with disappearing or involut ing brain lesions [1] is that a significant number of them are inflammatory and many, for lack of a better adage, 'idiopathic'. Such lesions have been described with demyelinating diseases, postepileptic changes [3,5], and parasitic lesions [2], but only as seen on CT scans.…”

mentioning

confidence: 99%

Spontaneous Involution of an Intra-Axial Brain Stem Lesion: A Case Report

Constantini

Gomori

et al. 1995

Pediatr Neurosurg

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This report describes the spontaneous involution of an intrinsic brain stem lesion whose clinical and MRI characteristics strongly suggest a tumor etiology. Nonoperative experiences with central nervous system tumors have shown that they may sometimes exhibit prolonged periods of dormancy. There are several reports of ‘disappearing’ CT lesions which have all been inflammatory, infective, or immunological. No histologically proven tumor has been shown to spontaneously involute, nor have ‘disappearing’ lesions been described for MRI.

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Disappearing CT lesions in epilepsy: is tuberculosis or cysticercosis the cause?

Cited by 40 publications

References 9 publications

Cysticercosis and Epilepsy: A Critical Review

Cysticercosis and Epilepsy: A Critical Review

Comparison of 1 week versus 4 weeks of albendazole therapy in single small enhancing computed tomography lesion

Spontaneous Involution of an Intra-Axial Brain Stem Lesion: A Case Report

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