Validation of diagnostic criteria for solitary cerebral cysticercus granuloma in patients presenting with seizures

Rajshekhar, Vedantam; Chandy, Mathew J.

doi:10.1111/j.1600-0404.1997.tb00243.x

Cited by 105 publications

(49 citation statements)

References 19 publications

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“…16,17 In addition, there is a wide range of disease entities with the same radiological picture. 20,21 International criteria as proposed by Del Brutto et al needs review in relation to Indian settings. 8,16 As included in these criteria, the visualisation of scolex is very important but it requires a more sensitive imaging technique than a CT scan and not every patient can be subjected to a MRI scan, therefore the inclusion of this criterion too needs revision.…”

Section: Discussionmentioning

confidence: 99%

Neurocysticercosis: clinical presentations, serology and radiological findings: experience in a teaching institution

Arora

Dhamija

2016

Int J Res Med Sci

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Section: Discussionmentioning

confidence: 99%

Neurocysticercosis: clinical presentations, serology and radiological findings: experience in a teaching institution

Arora

Dhamija

2016

Int J Res Med Sci

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“…24,25 A recent preliminary study suggested that the use of conformation-sensitive immunoassay may detect almost 50% of patients with a single cysticercal granuloma who were negative with the EITB, thus improving the sensibility of the test. 26 Moreover, as antibody detection in serum reflects cysticercus infection in any tissue, not only patients with NCC, but also 27 Cysticercirelated enhancing lesions are smaller than 20 mm in diameter, are most often located supratentorially, and rarely cause displacement of the midline or focal neurological deficits. 27,28 When these lesions resolve spontaneously, either disappearing or transforming into a calcified nodule, the diagnosis of NCC is almost certain.…”

Section: Major Diagnostic Criteriamentioning

confidence: 99%

“…26 Moreover, as antibody detection in serum reflects cysticercus infection in any tissue, not only patients with NCC, but also 27 Cysticercirelated enhancing lesions are smaller than 20 mm in diameter, are most often located supratentorially, and rarely cause displacement of the midline or focal neurological deficits. 27,28 When these lesions resolve spontaneously, either disappearing or transforming into a calcified nodule, the diagnosis of NCC is almost certain. Solitary cysticercus granuloma account for most cases of NCC reported from India, and are also prevalent in other regions of the world where this disease is endemic.…”

Section: Major Diagnostic Criteriamentioning

confidence: 99%

“…Solitary cysticercus granuloma account for most cases of NCC reported from India, and are also prevalent in other regions of the world where this disease is endemic. [27][28][29][30] Resolution of a ring-enhancing intracranial lesion with the use of steroids should not be considered as a major criterion for NCC, because other diseases that present with similar findings (i.e. intracranial lymphomas) may also vanish after steroid therapy.…”

Section: Major Diagnostic Criteriamentioning

confidence: 99%

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Diagnostic criteria for neurocysticercosis, revisited

Brutto

2012

Pathogens and Global Health

107

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Diagnosis of neurocysticercosis (NCC) can be a challenge. Clinical manifestations are non-specific, most neuroimaging findings are non-pathognomonic, and some serologic tests have low sensitivity or specificity. A set of diagnostic criteria was proposed in 2001 to avoid the over diagnosis of NCC that occurs in epidemiologic surveys, and to help clinicians evaluating patients with suspected NCC. The set included four stratified categories of criteria, including: (1) absolute: histological demonstration of cysticerci, cystic lesions showing the scolex on neuroimaging studies, and direct visualization of subretinal parasites by fundoscopic examination; (2) major: lesions highly suggestive of NCC on neuroimaging studies, positive serum enzyme-linked immunoelectrotransfer blot (EITB) for the detection of anticysticercal antibodies, resolution of intracranial cystic lesions after cysticidal drug therapy, and spontaneous resolution of single enhancing lesions; (3) minor: lesions compatible with NCC on neuroimaging studies, suggestive clinical manifestations, positive cerebrospinal fluid (CSF) ELISA for detection of anticysticercal antibodies or cysticercal antigens, and cysticercosis outside the nervous system; and (4) epidemiological: evidence of a household contact with Taenia solium infection, individuals coming from or living in cysticercosis endemic areas, and history of travel to disease-endemic areas. Interpretation of these criteria permits two degrees of diagnostic certainty: (1) definitive diagnosis, in patients who have one absolute criterion or in those who have two major plus one minor and one epidemiological criteria; and (2) probable diagnosis, in patients who have one major plus two minor criteria, in those who have one major plus one minor and one epidemiological criteria, and in those who have three minor plus one epidemiological criteria. After 10 years of usage, this set has been proved useful in both, field studies, and hospital settings. Recent advances in neuroimaging and immune diagnostic methods have enhanced its accuracy for the diagnosis of NCC.

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“…An eccentric nodule was supposed to represent the scolex. 12 Exclusion criteria. The patients with systemic malignancy, systemic tuberculosis, human immunodeficiency virus infection, pregnancy, progressive neurological deficit, raised intracranial tension, and hydrocephalus were excluded.…”

Section: Methodsmentioning

confidence: 99%

Predictors of Lesion Calcification in Patients with Solitary Cysticercus Granuloma and New-Onset Seizures

Mahajan¹,

Malhotra²,

Garg³

et al. 2016

The American Society of Tropical Medicine and Hygiene

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Abstract. Solitary cysticercus granuloma is a common neuroimaging abnormality in Indian patients with new-onset epilepsy. Calcific transformation of cysticercus granuloma is frequently associated with seizure recurrence. We evaluated predictors of lesion calcification in patients with solitary cysticercus granuloma and new-onset seizures. One hundred twenty-two patients, with new-onset seizures and a solitary cysticercus granuloma of the brain, were enrolled. All patients were clinically and radiologically evaluated and were treated with antiepileptic drug drugs. No patient received albendazole or corticosteroids. The follow-up period was of 1 year. Follow-up computed tomography was performed after 3 and 6 months. In 68 (54.8%) patients, solitary cysticercus granuloma had transformed into a calcified lesion. On logistic regression analysis, moderate-to-severe edema was a significant factor that predicted calcific transformation of the cysticercus granuloma (odds ratio: 3.325; 95% confidence interval: 1.502-7.362). During 1 year of follow-up, 19 (15.6%) patients experienced seizure recurrence. In 16 patients with seizure recurrence, cysticercus granuloma had transformed in to a calcified lesion. In conclusion, in solitary cysticercus granuloma, calcification of the lesion can be predicted if larger amount of perilesional edema is present. Calcification of the granuloma significantly predicts seizure recurrence.

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Validation of diagnostic criteria for solitary cerebral cysticercus granuloma in patients presenting with seizures

Cited by 105 publications

References 19 publications

Neurocysticercosis: clinical presentations, serology and radiological findings: experience in a teaching institution

Neurocysticercosis: clinical presentations, serology and radiological findings: experience in a teaching institution

Diagnostic criteria for neurocysticercosis, revisited

Predictors of Lesion Calcification in Patients with Solitary Cysticercus Granuloma and New-Onset Seizures

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