Prednisolone-Responsive Headache in Patients With Solitary Cysticercus Granuloma and Seizures

Authors

  • Ravindra Kumar Garg DM,

    1. Department of Neurology, Chhatrapati Shahuji Maharaj Medical University, (Upgraded King George's Medical College), Lucknow, India.
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  • Alok Mohan Kar DM,

    1. Department of Neurology, Chhatrapati Shahuji Maharaj Medical University, (Upgraded King George's Medical College), Lucknow, India.
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  • Maneesh Kumar Singh DM

    1. Department of Neurology, Chhatrapati Shahuji Maharaj Medical University, (Upgraded King George's Medical College), Lucknow, India.
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Address all correspondence to Dr. Ravindra Kumar Garg, Department of Neurology, Chhatrapati Shahuji Maharaj Medical University, (Upgraded King George's Medical College), Lucknow, India 226003.

Abstract

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.

Conclusion.—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.

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