Department of Neurology, Dayanand Medical College, Ludhiana, Punjab, India
Neurology. 2010 Dec 14;75(24):2236-45. doi: 10.1212/WNL.0b013e31820202dc.
Solitary cysticercus granuloma (SCG) is one of the most common forms of presentation of neurocysticercosis (NCC). The diagnostic workup and management approach to this condition remain uncertain and controversial.
To review evidence and develop a consensus approach to the diagnosis and treatment of SCG.
A multidisciplinary expert group meeting was convened in order to review and discuss various aspects of management of patients with SCG. Evidence reviewed was classified and a consensus was evolved according to standard protocols.
SCG is commonly recognized on CT as an enhancing lesion measuring <20 mm. Further evaluation with MRI does not add much information. The use of antihelminthic agents (specifically, albendazole in combination with corticosteroids) and corticosteroids alone have been shown to improve radiologic resolution and seizure outcome in patients with SCG. However, the sizes of the effects are modest. By convention, all patients with SCG presenting with seizures are initiated on antiepileptic drugs (AEDs). Available evidence suggests that withdrawal of AEDs after complete resolution of the SCG is safe. There is a high risk of seizure relapse after AED withdrawal in patients with calcific residue following resolution of the SCG. The duration of AED prophylaxis in these individuals is unclear.
It is desirable to have large, multicenter trials with sufficiently long follow-up, comparing outcomes with the use of antihelminthics with or without corticosteroids and corticosteroids alone in order to dissect out the benefits accrued due to each of these classes of drugs.
孤立性囊尾蚴肉芽肿（SCG）是神经囊尾蚴病（NCC）最常见的表现形式之一。该病症的诊断和治疗方法仍不确定且存在争议。
回顾相关证据并制定 SCG 的诊断和治疗共识方法。
召集一个多学科专家组会议，以审查和讨论 SCG 患者管理的各个方面。对审查的证据进行分类，并根据标准协议达成共识。
SCG 在 CT 上通常表现为<20mm 的增强病变。进一步的 MRI 评估没有增加太多信息。抗蠕虫药物（特别是阿苯达唑联合皮质类固醇）和皮质类固醇单独使用已被证明可改善 SCG 患者的影像学缓解和癫痫发作结果。然而，这些效果的幅度较小。根据惯例，所有因癫痫发作而出现 SCG 的患者均开始使用抗癫痫药物（AEDs）。现有证据表明，在 SCG 完全消退后，停用 AEDs 是安全的。在 SCG 消退后钙化残留的患者中，AED 停药后癫痫复发的风险很高。这些患者 AED 预防的持续时间尚不清楚。
需要进行具有足够长期随访的大型多中心试验，比较使用抗蠕虫药物联合或不联合皮质类固醇以及单独使用皮质类固醇的结果，以剖析每种药物类别带来的益处。
