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Query: UMLS:C0036572 (seizures)
 80,221 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Sixty-seven patients with epilepsy and isolated enhancing computed tomography (CT) scan lesion were studied with magnetic resonance imaging (MRI). Fifty-six patients (83.5%) had partial seizures and 11 (16.4%) had generalized seizures. Four distinct groups were identified by MRI: nonspecific 16 cases (23.8%), tuberculoma 38 cases (56.7%), cysticercosis 12 cases (17.9%), and abscess 1 case (1.4%). Patients in the non-specific group had lesions that were hyperintense on T2 images and hypointense or isointense on T1 images. Such lesions resolved completely in 5 months with serial MRIs while the patients were receiving antiepileptic drugs (AEDs). Virologic studies, including cerebrospinal fluid (CSF) serology, are suggested for patients with such MRI lesions.
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PMID:Magnetic resonance imaging evaluation of focal computed tomography abnormality in epilepsy. 186 4

Epilepsy is the commonest manifestation of neurocysticercosis. Epilepsy was observed in 127 of 150 cases (84.7%) of neurocysticercosis seen over a period of 17 years. The basis of diagnosis was clinical presentation and concomitant evidence of extraneural cysticercosis in the pre-computed tomography (CT) scan era, and typical CT findings in later years. Eighty one cases (54%) who primarily presented as epilepsy without any neurological deficit have been analysed in detail. In the pre-CT period the occurrence of epilepsy as a presenting feature in neurocysticercosis was 43.5% whereas in later years it was 61.4%. Primary generalised seizure (49 cases) was more common than partial seizure (29) and partial complex seizure (3). Status epilepticus was seen in 6 cases. Magnetic resonance imaging, done in 8 cases, proved to be more sensitive in demonstrating various stages in the development of noncalcified cysticercosis. The new larvicidal drugs offer a potential cure and cysticercosis should be entertained as a cause of epilepsy especially in endemic areas.
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PMID:Epilepsy as a manifestation of neurocysticercosis. 162 33

Thirty consecutive Indian patients with focal or generalised seizures and single, small (less than 10 mm), enhancing lesions on CT scans (SSECTL) were studied. Five patients (Group A) were treated with anticonvulsants alone and did not have a biopsy. In ten patients (Group B) a CT guided stereotaxic biopsy of the lesion was carried out and in the remainder (15-Group C) and excision biopsy of the lesion was carried out following CT guided stereotaxic localisation. In all patients in Group B the lesion were reported as "chronic nonspecific inflammation". In seven of 15 patients in Group C the lesions showed a cysticercus with a granuloma and in a further five the pathology was that of a "parasitic granuloma" but the parasite could not be identified. Biopsy did not reveal a tuberculoma or neoplasm in any of the patients. The lesions studied are the same as "disappearing" CT lesions reported in Indian patients, as in 12 of 15 patients in Groups A and B, who could be followed up for more than three months, the lesions had spontaneously disappeared or left calcific residues. It is concluded that in Indian epileptic patients with SSECTL cysticercosis is the commonest aetiology. A treatment protocol for these patients is suggested on the basis of the findings.
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PMID:Single small enhancing CT lesions in Indian patients with epilepsy: clinical, radiological and pathological considerations. 194 Sep 42

A prospective study of Nepalese adults (Gurkhas) based in Hong Kong who presented with adult-onset epileptiform seizures determined that cerebral cysticercosis was causative in 7 out of 8 cases. The relative roles of specific cysticercal serology and computerised axial tomography in diagnosis are discussed. Serum IgE levels were found to be raised in all patients with cerebral cysticercosis in the absence of other parasitic infection and reverted to normal after the patients were treated with praziquantel. Evidence suggests that the Gurkhas acquired their cysticercal infections in Nepal.
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PMID:Cerebral cysticercosis as a common cause of epilepsy in Gurkhas in Hong Kong. 226 27

The patient, a 52-year-old male, experienced a generalized convulsive seizure. Computed tomography (CT) revealed a solitary, noncalcified cyst, 1 x 2 cm in diameter, in the left occipital lobe, without contrast enhancement. No other lesions were found in systemic soft tissues, skeletal muscles, or the eyes. A CT-guided stereotactic biopsy was performed through an occipital burr hole, and the diagnosis was cerebral cysticercosis. Although cysticercosis is still common in Mexico, Chile, and India, its occurrence has rarely been reported in Japan, especially since World War II. Intraparenchymal calcification and cystic lesions are common CT findings. However, in this case, a non-enhancing solitary cyst was the only CT finding. The authors review the literature and discuss the CT features and the usefulness of CT-guided stereotactic biopsy in the diagnosis and treatment of cysticercosis.
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PMID:[Cerebral cysticercosis presenting as a solitary cyst. Diagnosis and treatment with CT-guided stereotactic biopsy--case report]. 247 56

Thirty-three patients with confirmed cysticercosis, with or without cerebral involvement, were treated with praziquantel at a daily dose of 75 mg/kg tid for 3 to 10 consecutive days and evaluated for tolerance and therapeutic effects. For dermal cysticercosis, a daily dose of 75 mg/kg tid for 3 days is effective. The nodules disappeared in one to 12 months after treatment. Twenty out of 33 patients with cysticercosis had cerebral cysticercosis. Among these 20 cases, 13 had epileptic seizures, 6 had a combination of both epileptic seizures and intracranial hypertension, and one had headache. The efficacy of the treatment of cerebral cysticercosis was assessed by the frequency of convulsions before and after treatment, and by the disappearance or decreased densities of the cystic lesions at brain CT scanning (6 months follow up). A daily dose of 75 mg/kg tid for 7 to 10 days (total 525 to 750 mg/kg) seems to be effective for the treatment of cerebral cysticercosis. The concomitant oral administration of dexamethasone during the course of treatment was effective for preventing and minimizing side effects. Praziquantel was very well tolerated.
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PMID:Clinical evaluation of the therapeutic efficacy of praziquantel against human cysticercosis. 248 2

The initial assessment of the young adult patient with multiple intracerebral lesions is challenging. The etiologic factors must be categorized as neoplastic, infectious, inflammatory, vascular, and hematologic, among others. Unfortunately, these lesions are not easily accessible for sampling, and all other diagnostic methods must first be exhausted. This case report describes a patient who was brought to an emergency department in New Jersey after her first seizure. The diagnosis was cerebral cysticercosis, an intracerebral parasitic infection that is extremely rare in this area but very common in other areas of the world. As more and more people immigrate to the United States, researchers believe that cerebral cysticercosis will become more common. It is imperative, therefore, for primary care physicians to understand this disease and to consider it in the appropriate setting.
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PMID:Cerebral cysticercosis. A disease to suspect in recent travelers or immigrants. 317 18

A case of sudden death from cysticercosis cerebri is described. A 38-year-old Ecuadorian woman suffered from headache for a few weeks which was interpreted as migraine. Later she developed extremely severe headache with seizures and died. A forensic autopsy showed normal organs. Neuropathologic examination revealed cysticercosis racemosus with reactive chronic ependymitis and meningitis and secondary hydrocephalus.
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PMID:Sudden death from cerebral cysticercosis. 322 78

Cerebral cysticercosis is being diagnosed with increasing frequency in children in the United States. A total of 52 patients with intraparenchymal cerebral cysticercosis, 21 months to 20 years of age, were observed for 2 to 72 months. Actively inflamed acute lesions, with or without coexisting chronic calcified lesions, were seen in 42 patients. Solitary lesions were seen in 39 patients, multiple lesions in 13. Chronic inactive calcified lesions were seen in ten children. A total of 51 patients had seizures that were either partial or partial with secondary generalization. Patients were treated with anticonvulsants. Praziquantel was not used. All active lesions resolved completely or with punctate calcification in 2 to 9 months, according to radiographic findings. Seizures were easily controlled. Patients were gradually weaned from anticonvulsants and in 60% no seizures recurred. Prognosis was generally good. Characteristics of the CT scans are detailed.
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PMID:Intraparenchymal cerebral cysticercosis in children: diagnosis and treatment. 328 59

Neurocysticercosis has become more prominent in the United States in recent years because of an increase in immigration from endemic regions and because of improved ease of diagnosis with computed tomography (CT). Neurocysticercosis should be suspected in any patient from a high-risk region who has symptoms or signs of a central nervous system disorder, especially seizures, headaches, or signs of increased intracranial pressure. The best diagnostic test is CT of the head, which usually shows a combination of multiple punctate calcifications; hydrocephalus; and parenchymal, subarachnoid, or intraventricular cysts with and without contrast enhancement. Cysticercosis is confirmed serologically by measurement of cysticercosis antibody titers in serum or cerebrospinal fluid and histologically by biopsy of a lesion. Treatment with praziquantel and dexamethasone is usually sufficient, but ventricular shunting or surgical removal of intraventricular or spinal cysts may be necessary. Whenever a case is identified, other household members should be examined for symptoms and signs of neurocysticercosis and screened for active Taenia solium infection.
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PMID:Neurocysticercosis in the United States: 35 cases and a review. 331 39


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