Role of antiparasitic therapy for seizures and resolution of lesions in neurocysticercosis patients: An 8 year randomised study

Das, Krishnapada; Mondal, Gobinda; Banerjee, Mousumi; Mukherjee, Bijoy; Singh, Om Prakash

doi:10.1016/j.jocn.2006.09.004

Cited by 48 publications

(46 citation statements)

References 14 publications

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“…The combination treatment led to increased hospital admission, increased seizure frequency, more cases of encephalopathy and deaths. A greater proportion of lesions calcified compared to the group that was treated with antiepileptic drugs alone, in which more lesions resolved completely [135].…”

Section: Treatment In the Absence Of Neuroimagingmentioning

confidence: 85%

Epilepsy and Neurocysticercosis in Sub-Saharan Africa

Sylvia¹

2013

Novel Aspects on Cysticercosis and Neurocysticercosis

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Section: Treatment In the Absence Of Neuroimagingmentioning

confidence: 85%

Epilepsy and Neurocysticercosis in Sub-Saharan Africa

Sylvia¹

2013

Novel Aspects on Cysticercosis and Neurocysticercosis

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“…In one study evaluating single enhancing lesions in young patients in India, approximately 10–20% of NCC granulomas formed calcified lesions 32. Many studies have shown an association between the formation of calcified lesions and seizures,1, 2, 6, 33, 34 both of which may be more likely in subjects with a strong inflammatory response. Although the process by which calcifications form is not completely understood, a breakdown in the blood–brain barrier due to inflammation could allow calcium from the bloodstream to be deposited into the brain parenchyma 35, 36…”

Section: Discussionmentioning

confidence: 99%

Inflammation is a key risk factor for persistent seizures in neurocysticercosis

Herrick

Maharathi

Kim

et al. 2018

Ann Clin Transl Neurol

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ObjectiveWe conducted a retrospective, case–control study of neurocysticercosis patients to ascertain early markers that identify subjects likely to develop treatment‐resistant seizures.MethodsClinical histories and imaging studies from 38 neurocysticercosis patients who had been followed for 18 months after treatment were evaluated. Both pairwise and multifactorial analyses were conducted to identify factors associated with continued seizures.ResultsEleven of 38 patients continued to have seizures during the follow‐up period. On univariate analysis, the number of neurocysticercosis lesions, number of bands on the baseline neurocysticercosis western blot, edema volumes on follow‐up MRI scans, edema volume changes between baseline and follow‐up images, and proportion of calcified lesions with perilesional edema were all significantly increased in subjects who had persistent seizures during the 18‐month follow‐up period. On multivariate analyses using recursive partition and random forest algorithms, variables associated with persistent seizures included: the number of total and calcified lesions, presence of perilesional edema, the rate of change in the lesion and edema volumes from baseline to follow‐up, and the number of bands on the neurocysticercosis western blot.InterpretationMeasures of both inflammation and disease burden are key risk factors for persistent seizures despite anticonvulsant treatments in patients with neurocysticercosis. Inflammation is therefore a potentially modifiable risk factor for the frequently seen severe seizure disorders in patients with neurocysticercosis.

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“…We excluded 169 because they were reviews, case reports, letters to editor, editorials, case series, retrospective studies, nonparenchymal neurocysticercosis studies, or active comparator trials (comparing 2 agents, e.g., albendazole with praziquantel). Full texts of the remaining 31 were reviewed; 16 were excluded because these contained data previously published, [16][17][18] 4 RCTs studied agents other than anthelminthics or corticosteroids, [19][20][21][22] 5 included patients with multiple enhancing or cystic lesions, 13,[23][24][25][26] and 4 had no control group for comparison. [27][28][29][30] Eventually, 10 RCTs, involving 765 subjects with SCG, were included in the meta-analysis of anthelminthic treatment.…”

Section: 15mentioning

confidence: 99%

Drug therapy for solitary cysticercus granuloma

et al. 2013

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Objective: The effectiveness of anthelminthic and corticosteroid drug therapy in parenchymal neurocysticercosis is well established. The treatment of parenchymal solitary cysticercus granuloma (SCG), however, remains controversial. We attempted to obtain a consistent estimate of the efficacy of anthelminthic and corticosteroid drug treatment in SCG.Methods: Randomized-controlled trials (RCTs) comparing rates of seizure freedom, granuloma resolution, and residual calcification in individuals with SCG treated with anthelminthic or corticosteroid drugs with those treated with antiepileptic drugs (AEDs) alone were systematically reviewed and quantified using fixed-or random-effects meta-analysis.Results: Fifteen RCTs were identified for inclusion. Ten RCTs assigned 765 people with SCG to AED treatment with or without anthelminthic drug (albendazole) treatment. A further 5 RCTs assigned 457 people with SCG to AED treatment with or without corticosteroid drugs. Anthelminthic treatment was associated with significantly increased rates of seizure freedom (nonevent odds ratio: 2.45; 95% confidence interval: 1.49-4.03; p 5 0.0004) and significantly higher rates of granuloma resolution (odds ratio: 2.09; 95% confidence interval: 1.41-3.00; p 5 0.0003), but did not alter the risk of residual calcification. Corticosteroid treatment was not significantly associated with any outcome. Conclusions:

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Role of antiparasitic therapy for seizures and resolution of lesions in neurocysticercosis patients: An 8 year randomised study

Cited by 48 publications

References 14 publications

Epilepsy and Neurocysticercosis in Sub-Saharan Africa

Epilepsy and Neurocysticercosis in Sub-Saharan Africa

Inflammation is a key risk factor for persistent seizures in neurocysticercosis

Drug therapy for solitary cysticercus granuloma

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