Del Brutto O H, Santibañez R, Noboa C A, Aguirre R, Díaz E, Alarcón T A
Neurologic Service, Hospital Regional del Instituto Ecuatoriano de Seguridad Social, Guayaquil, Ecuador.
Neurology. 1992 Feb;42(2):389-92. doi: 10.1212/wnl.42.2.389.
We reviewed clinical, EEG, and CT findings of 203 patients with epilepsy due to neurocysticercosis. Seizures were generalized in 121 patients and partial in 82. Thirty-two patients had focal signs and eight had papilledema. Eighty-one had generalized and 16 had focal EEG abnormalities. CT showed parenchymal brain calcifications in 53 patients and cysts in 150. There was an increased rate of focal signs in patients with single cysts as compared with patients with multiple cysts, and focal EEG abnormalities were present only in patients with single cysts. Fifty patients were lost to follow-up. The remaining 153 patients were followed for 28 +/- 6 months; of these, 31 had calcifications and 122 had cysts. Anticonvulsants were started after the first visit in every patient. The 31 patients with calcifications remained free of seizures. Ninety-five of the 122 patients with cysts were also treated with anticysticercal drugs; of these, 79 (83%) had control of seizures. In contrast, only seven (26%) of 27 patients who did not receive anticysticercal drugs had control of seizures, indicating a strong correlation between the use of anticysticercal drugs and seizure control. Finally, of the 21 patients in whom anticonvulsants were withdrawn, 16 had relapses.
我们回顾了203例神经囊尾蚴病所致癫痫患者的临床、脑电图及CT检查结果。121例患者发作类型为全身性发作,82例为部分性发作。32例患者有局灶性体征,8例有视乳头水肿。81例有全身性脑电图异常,16例有局灶性脑电图异常。CT显示53例患者脑实质有钙化,150例有囊肿。与多囊肿患者相比,单囊肿患者局灶性体征发生率更高,且仅单囊肿患者有局灶性脑电图异常。50例患者失访。其余153例患者随访28±6个月;其中31例有钙化,122例有囊肿。所有患者在首次就诊后均开始使用抗惊厥药物。31例有钙化的患者未再发作。122例有囊肿的患者中,95例还接受了抗囊尾蚴药物治疗;其中79例(83%)癫痫得到控制。相比之下,27例未接受抗囊尾蚴药物治疗的患者中只有7例(26%)癫痫得到控制,这表明使用抗囊尾蚴药物与癫痫控制之间有很强的相关性。最后,在21例停用抗惊厥药物的患者中,16例复发。