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Short‐course of prednisolone in solitary cysticercus granuloma: A randomized, double‐blind, placebo‐controlled trial
Author(s) -
Singla Monika,
Prabhakar Sudesh,
Modi Manish,
Medhi Bikash,
Khandelwal Niranjan,
Lal Vivek
Publication year - 2011
Publication title -
epilepsia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.687
H-Index - 191
eISSN - 1528-1167
pISSN - 0013-9580
DOI - 10.1111/j.1528-1167.2011.03184.x
Subject(s) - medicine , prednisolone , placebo , magnetic resonance imaging , cysticercus , epilepsy , lesion , randomized controlled trial , surgery , anesthesia , cysticercosis , gastroenterology , nuclear medicine , radiology , pathology , alternative medicine , psychiatry
Summary Purpose: To determine the effect of administration of a short course of prednisolone on seizure and radiologic outcome in patients with solitary cysticercus granuloma (SCG). Methods: One hundred forty‐eight subjects presenting with new‐onset seizures (<15 days duration) and with SCG demonstrated on imaging studies were randomly allocated to either treatment with prednisolone (40–60 mg/day for 2 weeks) or placebo in addition to standard antiepileptic drug therapy. The subjects were followed up for seizure recurrence for 9 months. Repeat computed tomography (CT, at 3 months) and magnetic resonance imaging (MRI, at 6 months) to evaluate resolution and calcification of the lesion. Key Findings: There was no difference in the proportion of subjects with seizure recurrence during the follow‐up period in the treatment (n = 16, 21.9%) and control (n = 19, 25.33%) groups (p = 0.7). However, generalized seizures occurred in a significantly lesser proportion of subjects in the treatment group (n = 3, 15.79%) in comparison to the control group (n = 12, 60.00%) (p = 0.015). There were no significant differences in the proportion of subjects with complete resolution of the SCG on repeat CT at 3 months [treatment group (27, 46.7%) and control group (23, 39.8%); p = 0.453] and repeat MRI at 6 months [treatment group (28, 46.7%) and control group (21, 38.9%); p = 0.402]. Significance: The administration of a short course of prednisolone does not offer significant improvement in seizure control, although a benefit in terms of reducing the likelihood of generalized seizures is possible. Furthermore, it does not improve the chances of resolution of the SCG on follow‐up imaging studies.