RESUMEN
BACKGROUND: Albendazole therapy has been found effective in solitary cysticercus granuloma. An optimal duration of albendazole therapy is not exactly known. Even 3-day therapy has been found effective. METHODS: We included 105 patients of new-onset seizures and solitary cysticercus granuloma. We compared 3-day albendazole therapy and 15-day therapy with a control group. Each group had 35 patients. This was an open-label randomized trial. Patients were followed for 6 months. MRI was done after 6 months. Seizure recurrences during follow-up were noted. RESULTS: After 6 months, albendazole group, in comparison to placebo group, had significantly higher proportion (43/70 versus 13/35) of patients in whom lesion had disappeared. Albendazole treatment for 15 days was insignificantly better in comparison to 3-day treatment regimen. In 15-day albendazole group lesser number of lesions (2.8%) was calcified than 3-day albendazole group (8.57%) or no treatment group (20%). After 6 months of follow-up, seizure recurrence was seen in 20 (19%) patients. The majority (15/20) of patients, experiencing seizure recurrence, had an abnormal follow-up MRI. Five patients had seizures despite normal MRI. CONCLUSION: In conclusion, albendazole was significantly better in producing lesion resolution. A 15-day treatment with albendazole was better than 3-day treatment. Albendazole, possibly, led to less number of lesions got calcified and possibly, there was less risk of seizure recurrence.
Asunto(s)
Albendazol/administración & dosificación , Antihelmínticos/administración & dosificación , Cysticercus , Granuloma/tratamiento farmacológico , Neurocisticercosis/tratamiento farmacológico , Adolescente , Adulto , Animales , Niño , Preescolar , Esquema de Medicación , Femenino , Estudios de Seguimiento , Granuloma/complicaciones , Granuloma/diagnóstico , Humanos , Masculino , Persona de Mediana Edad , Neurocisticercosis/complicaciones , Neurocisticercosis/diagnóstico , Convulsiones/diagnóstico , Convulsiones/tratamiento farmacológico , Convulsiones/etiología , Adulto JovenRESUMEN
Brainstem alone is involved very infrequently in patients with neurocysticercosis; usually, it occurs in association with disseminated form of the disease. Isolated involvement of the third nerve is commonly due to vascular causes. We are reporting a case due to cysticercus lesion presenting as isolated third-nerve involvement with sparing of the pupil. The diagnosis of neurocysticercosis was established by the presence of characteristic granulomatous lesions in the midbrain along with positive ELISA for cysticercal antigen in the cerebrospinal fluid. The patient responded well to corticosteroids with almost complete recovery. A follow-up MRI scan showed a significant decrease in the size of the lesion.