Short course of prednisolone in Indian patients with solitary cysticercus granuloma and new-onset seizures.
OBJECTIVE
To evaluate the role of a short course of oral corticosteroids in Indian patients with solitary cysticercus granuloma with seizures.


METHODS
In this open-label, randomized, prospective follow-up study, 97 patients with new-onset seizures and a single enhancing computed tomography (CT)-detected lesion of cysticercosis were randomly divided in two groups to receive either antiepileptic monotherapy alone (n = 48) or antiepileptic monotherapy with prednisolone (n = 49). The patients in the latter group received prednisolone, 1 mg/kg/day for 10 days, followed by tapering over next 4 days. The patients were followed up for 6 months. Repeated CT scans were performed after 1 and 6 months.


RESULTS
The majority of patients were young. Simple partial seizure, with or without secondary generalization, was the commonest seizure type encountered. Follow-up CT scans at 1 and 6 months demonstrated a significantly better response for prednisolone as far as complete resolution of CT lesion was concerned. Kaplan-Meier analysis suggested significantly less probability of seizure recurrence for prednisolone-treated patients. At 6 months, Kaplan-Meier estimated risk of seizure after first seizure was 2% in prednisolone-treated patients in comparison to 13% for those who were not given prednisolone.


CONCLUSIONS
Short-term prednisolone therapy helps in rapid resolution of solitary cysticercus granuloma in Indian patients with new-onset seizures. Resolution of lesions is associated with improved seizure-related prognosis.
Mall
Ravi Kant
RK
Department of Neurology, Chhatrapati Shahuji Maharaj Medical University (Upgraded King George's Medical College), Lucknow, India.
Agarwal
Atul
A
Garg
Ravindra Kumar
RK
Kar
Alok Mohan
AM
Shukla
Rakesh
R
D000293:Adolescent; D000328:Adult; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage* / Q000009:adverse effects; D000927:Anticonvulsants / Q000008:administration & dosage / Q000009:adverse effects; D002648:Child; D003906:Developing Countries; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D004828:Epilepsies, Partial / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000209:etiology; D004829:Epilepsy, Generalized / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D015745:Granuloma, Foreign-Body / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000209:etiology; D006801:Humans; D007194:India; D008297:Male; D020019:Neurocysticercosis / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy*; D011239:Prednisolone / Q000008:administration & dosage* / Q000009:adverse effects; D011446:Prospective Studies; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D000893:Anti-Inflammatory Agents; D000927:Anticonvulsants; D011239:Prednisolone