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Surgical Treatment for Mesial Temporal Lobe Epilepsy in the Presence of Massive Calcified Neurocysticercosis.

Authors :
Wichert-Ana, Lauro
Velasco, Tonicarlo Rodrigues
Terra-Bustamante, Vera Cristina
Alexandre Jr., Veriano
Walz, Roger
Bianchin, Marino M.
Leite, João Pereira
Assirati, João Alberto
Carlotti, Carlos Gilberto
Araújo, David
Santos, Antonio Carlos
Takayanagui, Osvaldo Massaiti
Sakamoto, Américo Ceiki
Source :
Archives of Neurology; Jul2004, Vol. 61 Issue 7, p1117-1119, 3p
Publication Year :
2004

Abstract

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. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
00039942
Volume :
61
Issue :
7
Database :
Complementary Index
Journal :
Archives of Neurology
Publication Type :
Academic Journal
Accession number :
13839379
Full Text :
https://doi.org/10.1001/archneur.61.7.1117