New solitary cysticercus granulomas causing recurrent symptoms in patients with resolved solitary granulomas.
Recurrence of symptoms in a patient with a resolved solitary cerebral cysticercus granuloma (SCCG) is uncommon. Recurrent seizures in these patients are generally attributed to an epileptogenic scar or calcific residue of the granuloma. We report two patients with recurrent seizures and one patient with headache; all three patients were previously diagnosed to have SCCG and had complete resolution of the granuloma on follow-up imaging. Computed tomography (CT) at the time of recurrent symptoms showed a SCCG at a site different from the initial lesion, but in the same cerebral hemisphere in all the three patients. Since a new lesion can cause recurrent symptoms in patients with a resolved SCCG, repeat imaging should be performed in all these patients. We also postulate that recurrent cysticercal lesions in patients who have previously had a SCCG, tend to be solitary.
Department of Neurological Sciences, Christian Medical College and Hospital, Vellore, India.
G Samson
GS
Sujit Kumar
Vedantam
V
Rajshekhar
D000818:Animals; D001927:Brain Diseases / Q000150:complications* / Q000000981:diagnostic imaging; D002648:Child; D002675:Child, Preschool; D003552:Cysticercus; D005260:Female; D006099:Granuloma / Q000000981:diagnostic imaging / Q000469:parasitology*; D006261:Headache / Q000209:etiology; D006801:Humans; D008297:Male; D020019:Neurocysticercosis / Q000150:complications* / Q000000981:diagnostic imaging; D012008:Recurrence; D012640:Seizures / Q000209:etiology; D014057:Tomography, X-Ray Computed