BACKGROUND: Neurocysticercosis (NCC) is the most common parasitic disease of the human central nervous system and a major health problem for most developing countries. The most common clinical manifestations of NCC are epileptic seizures. Whenever epilepsy and NCC coexist in the same patient, an uncertainty may rise about a causal relationship between them. OBSERVATION: We described a female patient with disseminated calcified NCC lesions and intractable epilepsy. Her medical history included cysticercotic meningoencephalitis and status epilepticus caused by active NCC. Fundoscopy showed the ocular presence of parasite; computed tomography of the brain showed evidence of cystic lesions with the scolex and calcified lesions; enzyme-linked immunosorbent assay of the cerebrospinal fluid was positive for cysticercosis. Epileptic seizures started after an 8-year silent period. Magnetic resonance imaging showed left hippocampal sclerosis. Plain x-ray film showed calcifications in muscles and subcutaneous tissue. Video-electroencephalography and ictal and interictal single-photon emission computed tomography disclosed left mesial temporal lobe epilepsy. The patient underwent left temporal lobectomy and has been seizure free since surgery, for a follow-up of 4 years. CONCLUSION: This case report highlights and supports surgical therapy in patients with epileptic seizures and calcified NCC, even when there are several calcifications, provided that clear localization of epilepsy has been determined by means of a presurgical workup.
BACKGROUND:Neurocysticercosis (NCC) is the most common parasitic disease of the human central nervous system and a major health problem for most developing countries. The most common clinical manifestations of NCC are epileptic seizures. Whenever epilepsy and NCC coexist in the same patient, an uncertainty may rise about a causal relationship between them. OBSERVATION: We described a female patient with disseminated calcified NCC lesions and intractable epilepsy. Her medical history included cysticercotic meningoencephalitis and status epilepticus caused by active NCC. Fundoscopy showed the ocular presence of parasite; computed tomography of the brain showed evidence of cystic lesions with the scolex and calcified lesions; enzyme-linked immunosorbent assay of the cerebrospinal fluid was positive for cysticercosis. Epileptic seizures started after an 8-year silent period. Magnetic resonance imaging showed left hippocampal sclerosis. Plain x-ray film showed calcifications in muscles and subcutaneous tissue. Video-electroencephalography and ictal and interictal single-photon emission computed tomography disclosed left mesial temporal lobe epilepsy. The patient underwent left temporal lobectomy and has been seizure free since surgery, for a follow-up of 4 years. CONCLUSION: This case report highlights and supports surgical therapy in patients with epileptic seizures and calcified NCC, even when there are several calcifications, provided that clear localization of epilepsy has been determined by means of a presurgical workup.
Authors: T E Nash; G Singh; A C White; V Rajshekhar; J A Loeb; J V Proaño; O M Takayanagui; A E Gonzalez; J A Butman; C DeGiorgio; O H Del Brutto; A Delgado-Escueta; C A W Evans; R H Gilman; S M Martinez; M T Medina; E J Pretell; J Teale; H H Garcia Journal: Neurology Date: 2006-10-10 Impact factor: 9.910
Authors: T R Velasco; P A Zanello; C L Dalmagro; D Araújo; A C Santos; M M Bianchin; V Alexandre; R Walz; J A Assirati; C G Carlotti; O M Takayanagui; A C Sakamoto; J P Leite Journal: J Neurol Neurosurg Psychiatry Date: 2006-04 Impact factor: 10.154
Authors: Marino M Bianchin; Tonicarlo R Velasco; Erica R Coimbra; Ana C Gargaro; Sara R Escorsi-Rosset; Lauro Wichert-Ana; Vera C Terra; Veriano Alexandre; David Araujo; Antonio Carlos dos Santos; Regina M F Fernandes; João A Assirati; Carlos G Carlotti; João P Leite; Osvaldo M Takayanagui; Hans J Markowitsch; Américo C Sakamoto Journal: PLoS One Date: 2013-04-22 Impact factor: 3.240