Abstract
Thirty consecutive Indian patients with focal or generalised seizures and single, small (less than 10 mm), enhancing lesions on CT scans (SSECTL) were studied. Five patients (Group A) were treated with anticonvulsants alone and did not have a biopsy. In ten patients (Group B) a CT guided stereotaxic biopsy of the lesion was carried out and in the remainder (15-Group C) and excision biopsy of the lesion was carried out following CT guided stereotaxic localisation. In all patients in Group B the lesion were reported as "chronic nonspecific inflammation". In seven of 15 patients in Group C the lesions showed a cysticercus with a granuloma and in a further five the pathology was that of a "parasitic granuloma" but the parasite could not be identified. Biopsy did not reveal a tuberculoma or neoplasm in any of the patients. The lesions studied are the same as "disappearing" CT lesions reported in Indian patients, as in 12 of 15 patients in Groups A and B, who could be followed up for more than three months, the lesions had spontaneously disappeared or left calcific residues. It is concluded that in Indian epileptic patients with SSECTL cysticercosis is the commonest aetiology. A treatment protocol for these patients is suggested on the basis of the findings.
Full text
PDFImages in this article
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Ahuja G. K., Behari M., Prasad K., Goulatia R. K., Jailkhani B. L. Disappearing CT lesions in epilepsy: is tuberculosis or cysticercosis the cause? J Neurol Neurosurg Psychiatry. 1989 Jul;52(7):915–916. doi: 10.1136/jnnp.52.7.915. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Basauri L., Zuleta A., Loayza P., Olivares A. Micro-abscesses and presumptive inflammatory nodules of the brain. Acta Neurochir (Wien) 1983;68(1-2):27–32. doi: 10.1007/BF01406199. [DOI] [PubMed] [Google Scholar]
- Chandy M. J., Rajshekhar V., Prakash S., Ghosh S., Joseph T., Abraham J., Chandi S. M. Cysticercosis causing single, small CT lesions in Indian patients with seizures. Lancet. 1989 Feb 18;1(8634):390–391. doi: 10.1016/s0140-6736(89)91771-6. [DOI] [PubMed] [Google Scholar]
- Crawford P. M., West C. R., Chadwick D. W., Shaw M. D. Arteriovenous malformations of the brain: natural history in unoperated patients. J Neurol Neurosurg Psychiatry. 1986 Jan;49(1):1–10. doi: 10.1136/jnnp.49.1.1. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Grisolia J. S., Wiederholt W. C. CNS cysticercosis. Arch Neurol. 1982 Sep;39(9):540–544. doi: 10.1001/archneur.1982.00510210010003. [DOI] [PubMed] [Google Scholar]
- Miller B., Grinnell V., Goldberg M. A., Heiner D. Spontaneous radiographic disappearance of cerebral cysticercosis: three cases. Neurology. 1983 Oct;33(10):1377–1379. doi: 10.1212/wnl.33.10.1377. [DOI] [PubMed] [Google Scholar]
- Rosas N., Sotelo J., Nieto D. ELISA in the diagnosis of neurocysticercosis. Arch Neurol. 1986 Apr;43(4):353–356. doi: 10.1001/archneur.1986.00520040039016. [DOI] [PubMed] [Google Scholar]
- Sethi P. K., Kumar B. R., Madan V. S., Mohan V. Appearing and disappearing CT scan abnormalities and seizures. J Neurol Neurosurg Psychiatry. 1985 Sep;48(9):866–869. doi: 10.1136/jnnp.48.9.866. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Tsang V. C., Brand J. A., Boyer A. E. An enzyme-linked immunoelectrotransfer blot assay and glycoprotein antigens for diagnosing human cysticercosis (Taenia solium). J Infect Dis. 1989 Jan;159(1):50–59. doi: 10.1093/infdis/159.1.50. [DOI] [PubMed] [Google Scholar]
- Vengsarkar U. S., Pisipaty R. P., Parekh B., Panchal V. G., Shetty M. N. Intracranial tuberculoma and the CT scan. J Neurosurg. 1986 Apr;64(4):568–574. doi: 10.3171/jns.1986.64.4.0568. [DOI] [PubMed] [Google Scholar]
- Wadia R. S., Makhale C. N., Kelkar A. V., Grant K. B. Focal epilepsy in India with special reference to lesions showing ring or disc-like enhancement on contrast computed tomography. J Neurol Neurosurg Psychiatry. 1987 Oct;50(10):1298–1301. doi: 10.1136/jnnp.50.10.1298. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Zegers De Beyl D., Hermanus N., Colle H., Goldman S. Focal seizures with reversible hypodensity on the CT scan. J Neurol Neurosurg Psychiatry. 1985 Feb;48(2):187–188. doi: 10.1136/jnnp.48.2.187. [DOI] [PMC free article] [PubMed] [Google Scholar]