14 year old boy with right focal seizure followed by postictal Todd's paralysis. Diagnosis and treatment?



Neurocysticercosis with perilesional edema .Start 1 Albendazole 15 mg per kg body weight or Praziquantel 50 mg per kg body weight for 3 weeks. 2 Tab Delazacort 12 mg O.D for 3 weeks. 3.Tab carbamazepine 200mg for 1 month

agree with Dr yograj sir

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It's an NCC... colloidal stage with perilesional edema... Start on albendazole under steroid cover with anti epileptics...

Lt side Parietal region SOCL, Perilesional Edema, Ring enhancing lesion. Abcsses Lt side Parietal region. Looks like Scolex. NCC Lt side Parietal Region D/D: T.B. Granuloma. Rx : 1st. to start with Steroid therapy, Decrease the Edema, Look for "FUNDUS EXAMINATION" If Viable CYSTICERCOSIS not found then start the actual therapy with ALBENDAZOLE for 29 days. Look for the Risk, & avoid in the future. ATT, if T.B. Granuloma.

Solitary( Neurocysticercosis with perilesional oedema(lt parietal) and minimal midline shift . D/d tuberculoma for solitary granuloma. T/t Albandazole or priziquintal. Previously we used to give for 3 month but now recommended for 3 weeks only.No antioedema drugs like mannitol or corticosteroid is required. Even role of Albandazole or like drugs are debated.As it is end stage infection and ultimately it end up in calcification,and treatment may lead to more reaction and oedema.ACT is must and seizure can be easily control by single drug but must be continued at least more than 3 yrs seizur free. Seen more than 100 such cases while in Dhanbad. Many of than multiple with generalised seizures. Surprised to note that as number of Neurocysticercosis was more oedema was less.One such case I still remembered that there were numerous Neurocysticercosis so much so that we were unable to count and they were everywhere in whole brain but no oedema and this case a male did not present as seizur but abnormal behavior(psychosis ).Now appears that cases of Neurocysticercosis are less now .

If u give albendazole without steroid support ...will lead to encephalopathy...I saw 2 such case in wch treatment make the situation worst ...so first give dexona thn tt of albendazole for 21 days or even albendazole is not much necessary

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granuloma in lt parietal lobe either tubercular on neurocysticercosis .anti edema management and anti epileptic drug ruleout cause tt according.

Thank you all. Its NCC, colloidal vesicular stage. Scolex is seen within the lesion- hole with dot appearance- bright spot of restriction on DWI. I have started Albendazole along with oral steroid for 2 weeks and AED oxcarbazepine.

Steroid is needed along with albendazole or not??

Todds will recover on own. Antiepileptics for 6 month to 1 year. Looks like NCC. Peri lesional edema and eccentric nodule in cyst. Closest DD in our country is tuberculoma. MRS can help if is shows lipid lactate peak - suggest tuberculoma.

A case of neuro cysticercosis. tt albendazole. defazacort. carbamazepine. follow up & review. ..after 8-10wks. ...

NCC with perilesional edema. dd. tuberculoma

NCC for sure.

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