title: Prednisolone-responsive headache in patients with solitary cysticercus granuloma and seizures.
abstract: BACKGROUND
  Solitary cysticercus granuloma is the commonest imaging abnormality in Indian patients with new-onset seizures. Few patients, in addition, complain of disabling headache.
  
  
  OBJECTIVE
  To report our experience of 16 patients with new-onset headache, seizures, and solitary cysticercus granuloma.
  
  
  METHODS
  Sixteen consecutive patients, who had moderate to severe new-onset headache and fulfilled the diagnostic criteria of solitary cysticercus granuloma, were included in the study. The inclusion criteria were: occurrence of seizures, minimal or no neurologic deficit, absence of papilledema, no evidence of any systemic disorder, and computed tomography showing a single ring/disk-enhancing lesion of <20 mm in diameter. Patients received antiepileptic monotherapy, oral analgesics, and prednisolone (1.5 mg/kg/day for 7 days). Prednisolone was then tapered over the next 7 days. Patients were followed for 6 months. Follow-up computed tomography was performed after 2 months; in all 16 patients, the scans showed complete disappearance of the lesion.
  
  
  RESULTS
  After 14 days (at first follow-up), all patients reported significant improvement in headache. Follow-up after 2 months revealed that all patients were headache-free. None of the patients reported any recurrence of headache.
  
  
  CONCLUSIONS
  This open-label study suggests the effectiveness of prednisolone for disabling headache in Indian patients with solitary cysticercus granuloma and seizures. There is a need, however, for more scientifically rigorous studies for further confirmation of our results.
authors.affiliation: Department of Neurology, Chhatrapati Shahuji Maharaj Medical University, (Upgraded King George's Medical College), Lucknow, India.
authors.forename: Ravindra Kumar
authors.initials: RK
authors.lastname: Garg
authors.forename: Alok Mohan
authors.initials: AM
authors.lastname: Kar
authors.forename: Maneesh Kumar
authors.initials: MK
authors.lastname: Singh
mesh_terms: D000328:Adult; D000818:Animals; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D003552:Cysticercus; D005260:Female; D015745:Granuloma, Foreign-Body / Q000150:complications* / Q000000981:diagnostic imaging / Q000469:parasitology; D006261:Headache / Q000188:drug therapy* / Q000209:etiology; D006801:Humans; D007194:India; D008297:Male; D020019:Neurocysticercosis / Q000150:complications* / Q000000981:diagnostic imaging; D011239:Prednisolone / Q000627:therapeutic use*; D012640:Seizures / Q000209:etiology*; D014057:Tomography, X-Ray Computed
chemical_list: D000893:Anti-Inflammatory Agents; D011239:Prednisolone