Mall Ravi Kant, Agarwal Atul, Garg Ravindra Kumar, Kar Alok Mohan, Shukla Rakesh
Department of Neurology, Chhatrapati Shahuji Maharaj Medical University (Upgraded King George's Medical College), Lucknow, India.
Epilepsia. 2003 Nov;44(11):1397-401. doi: 10.1046/j.1528-1157.2003.08003.x.
To evaluate the role of a short course of oral corticosteroids in Indian patients with solitary cysticercus granuloma with seizures.
In this open-label, randomized, prospective follow-up study, 97 patients with new-onset seizures and a single enhancing computed tomography (CT)-detected lesion of cysticercosis were randomly divided in two groups to receive either antiepileptic monotherapy alone (n = 48) or antiepileptic monotherapy with prednisolone (n = 49). The patients in the latter group received prednisolone, 1 mg/kg/day for 10 days, followed by tapering over next 4 days. The patients were followed up for 6 months. Repeated CT scans were performed after 1 and 6 months.
The majority of patients were young. Simple partial seizure, with or without secondary generalization, was the commonest seizure type encountered. Follow-up CT scans at 1 and 6 months demonstrated a significantly better response for prednisolone as far as complete resolution of CT lesion was concerned. Kaplan-Meier analysis suggested significantly less probability of seizure recurrence for prednisolone-treated patients. At 6 months, Kaplan-Meier estimated risk of seizure after first seizure was 2% in prednisolone-treated patients in comparison to 13% for those who were not given prednisolone.
Short-term prednisolone therapy helps in rapid resolution of solitary cysticercus granuloma in Indian patients with new-onset seizures. Resolution of lesions is associated with improved seizure-related prognosis.
评估短期口服皮质类固醇激素在患有癫痫的印度孤立性囊尾蚴肉芽肿患者中的作用。
在这项开放标签、随机、前瞻性随访研究中，97例新发癫痫且经计算机断层扫描（CT）检测到单个增强性囊尾蚴病病灶的患者被随机分为两组，分别接受单纯抗癫痫单药治疗（n = 48）或抗癫痫单药治疗联合泼尼松龙（n = 49）。后一组患者接受泼尼松龙治疗，剂量为1 mg/kg/天，共10天，随后在接下来的4天内逐渐减量。对患者进行6个月的随访。在1个月和6个月后进行重复CT扫描。
大多数患者较为年轻。单纯部分性发作，无论有无继发全身性发作，是最常见的发作类型。就CT病灶的完全消退而言，1个月和6个月时的随访CT扫描显示泼尼松龙的反应明显更好。Kaplan-Meier分析表明，泼尼松龙治疗的患者癫痫复发的可能性显著降低。在6个月时，Kaplan-Meier估计首次发作后泼尼松龙治疗患者的癫痫风险为2%，而未接受泼尼松龙治疗的患者为13%。
短期泼尼松龙治疗有助于印度新发癫痫患者的孤立性囊尾蚴肉芽肿快速消退。病灶的消退与癫痫相关预后的改善有关。
