Del Brutto O H
Department of Neurology, Luis Vernaza Hospital, Guayaquil, Ecuador.
J Neurol Neurosurg Psychiatry. 1995 Feb;58(2):247-9. doi: 10.1136/jnnp.58.2.247.
Fifty four patients with a single parenchymal brain cysticercus in the acute encephalitic phase were studied to outline the features of this form of the disease. Seizures were the presenting symptom in all cases. Twenty six patients had a single seizure and 28 had several seizures before admission. Neurological examination was normal in 45 patients and showed focal signs in nine. All patients had a single enhancing CT lesion; all but three lesions were < 20 mm. Anticonvulsants were started in every patient. Forty five patients were followed up for 18 (SD 6) months. Thirty seven of these 45 patients received albendazole. Four weeks after the trial, CT showed resolution of lesions in all cases. The remaining eight patients refused albendazole, and CT showed persistence of lesions by 16 weeks in six cases. At the end of the follow up, all patients who received albendazole were free of seizures as opposed to three of eight patients who did not receive the drug. Focal signs improved in the nine patients with these signs (all received albendazole). Recognition of this form of neurocysticercosis permits early treatment with albendazole that greatly improves the prognosis.
对54例处于急性脑炎期的单发脑实质囊尾蚴病患者进行了研究，以勾勒出这种疾病形式的特征。所有病例的首发症状均为癫痫发作。26例患者仅有一次癫痫发作，28例在入院前有多次癫痫发作。45例患者的神经系统检查正常，9例有局灶性体征。所有患者的CT均显示有单个强化病变；除3个病变外，所有病变均<20 mm。所有患者均开始使用抗惊厥药物。45例患者接受了18（标准差6）个月的随访。这45例患者中有37例接受了阿苯达唑治疗。试验4周后，CT显示所有病例的病变均消退。其余8例患者拒绝使用阿苯达唑，16周时CT显示6例患者的病变持续存在。随访结束时，所有接受阿苯达唑治疗的患者均无癫痫发作，而未接受该药物治疗的8例患者中有3例仍有癫痫发作。9例有局灶性体征的患者（均接受了阿苯达唑治疗）的局灶性体征有所改善。认识到这种神经囊尾蚴病形式后，可早期使用阿苯达唑治疗，这可大大改善预后。
