Prednisolone-responsive headache in patients with solitary cysticercus granuloma and seizures.
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.
Garg
Ravindra Kumar
RK
Department of Neurology, Chhatrapati Shahuji Maharaj Medical University, (Upgraded King George's Medical College), Lucknow, India.
Kar
Alok Mohan
AM
Singh
Maneesh Kumar
MK
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
D000893:Anti-Inflammatory Agents; D011239:Prednisolone