title: Seizure and radiological outcomes in children with solitary cysticercous granulomas with and without albendazole therapy: a retrospective case record analysis.
abstract: Neurocysticercosis, parasitic infestation of the central nervous system by the Taenia solium larvae, is a major public health problem, primarily in the developing countries. Seizures are the primary clinical manifestation which could be acute (secondary to active lesions) or remote symptomatic (due to calcified lesions). Cysticidal therapy is the standard of care for solitary parenchymal active neurocysticerci. However treatment related side effects and tendency to spontaneous resolution raises concern from time to time whether cysticidal therapy is actually required. This is a retrospective case record analysis of two groups of patients with solitary parenchymal neurocysticerci (group A; 171 patients between 2000 and 2004 who did not receive cysticidal therapy, group B; 512 patients between 2008 and 2013 who received cysticidal therapy). Group B had significantly more radiological resolution of lesions whereas group A reported significantly more seizure recurrences on antiepileptics. There was no significant difference in occurrence of calcification in the two groups. Overall patients with calcified lesions had significantly more breakthrough seizures. Well designed prospective studies should be planned in future to understand the mechanism underlying the epileptogenicity of calcified lesions and how they are linked to host and environment factors.
authors.affiliation: Division of Pediatric Neurology, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India. Electronic address: sheffalig@yahoo.com.
authors.forename: Sheffali
authors.initials: S
authors.lastname: Gulati
authors.affiliation: Division of Pediatric Neurology, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India. Electronic address: puneet_mpa@yahoo.com.
authors.forename: Puneet
authors.initials: P
authors.lastname: Jain
authors.affiliation: Division of Pediatric Neurology, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India. Electronic address: deepaksachan26@yahoo.com.
authors.forename: Deepak
authors.initials: D
authors.lastname: Sachan
authors.affiliation: Division of Pediatric Neurology, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India. Electronic address: biswaroopchakrabarty@gmail.com.
authors.forename: Biswaroop
authors.initials: B
authors.lastname: Chakrabarty
authors.affiliation: Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, India. Electronic address: dratinkumar@gmail.com.
authors.forename: Atin
authors.initials: A
authors.lastname: Kumar
authors.affiliation: Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India. Electronic address: rmpandey@yahoo.com.
authors.forename: R M
authors.initials: RM
authors.lastname: Pandey
authors.affiliation: Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, India. Electronic address: arunk676@gmail.com.
authors.forename: Arun K
authors.initials: AK
authors.lastname: Gupta
mesh_terms: D015766:Albendazole / Q000627:therapeutic use*; D000871:Anthelmintics / Q000627:therapeutic use*; D000927:Anticonvulsants / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006099:Granuloma / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000209:etiology; D006801:Humans; D007223:Infant; D008297:Male; D020019:Neurocysticercosis / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy*; D012189:Retrospective Studies; D012640:Seizures / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000209:etiology*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D000871:Anthelmintics; D000927:Anticonvulsants; D015766:Albendazole
keywords: Albendazole; Calcification; Epilepsy; Neurocysticercosis; Perilesional edema