[Temporal lobe epilepsy and active neurocysticercosis: two representative case reports]

Rev Neurol. 2015 Jan 1;60(1):30-4.
[Article in Spanish]

Abstract

Introduction: There are limited evidences reported of temporal lobe epilepsy associated with active cysticercosis in cystic stage. The objective is to present the correlation between active cysticercosis in topographical zones associated with temporal lobe epilepsy, with neuropsychiatric manifestations and pattern of secondarily generalized partial seizures.

Case reports: Two cases of adult patients with neuropsychiatric manifestations of one year evolution, refractory to antipsychotic drug treatment, and who subsequently appear late onset partial-secondarily generalized seizures. Cysticercosis active presence in the temporal lobe in one patient, and the insula in the other, is identified. A better clinical control after albendazol treatment and subsequently anticonvulsant therapy only remained to evaluate pertinence of pharmacological withdrawal criteria.

Conclusions: Active neurocysticercosis, may be the cause of acquired neuropsychiatric disorders and temporal lobe epilepsy of late onset when the topography is in the mesolimbic circuit. Early etiologic diagnosis and appropriate treatment allows adequate control of their symptoms and potentially final cure.

Title: Epilepsia del lobulo temporal y neurocisticercosis activa: dos casos representativos.

Introduccion. Existen pocas evidencias notificadas de casos de epilepsia del lobulo temporal asociadas a cisticercosis activa en su fase quistica. El objetivo es presentar la correlacion entre cisticercosis activa en zonas topograficas asociadas a epilepsia del lobulo temporal, con las manifestaciones neuropsiquiatricas y el patron de crisis parciales secundariamente generalizadas. Casos clinicos. Dos casos de pacientes adultos con manifestaciones neuropsiquiatricas de un año de evolucion, refractarios a tratamiento farmacologico antipsicotico, y en quienes posteriormente aparecen crisis convulsivas parciales secundariamente generalizadas de inicio tardio. Se identifica la presencia de cisticercosis activa en el lobulo temporal en un paciente, y en la insula, en el otro. Buen control clinico posterior al tratamiento con albendazol, pero se mantiene el mismo tratamiento anticonvulsionante para considerar la pertinencia de su retirada farmacologica. Conclusiones. La neurocisticercosis activa puede ser causa de trastornos neuropsiquiatricos adquiridos y de epilepsia del lobulo temporal de inicio tardio cuando su topografia se encuentra en el circuito mesolimbico. El diagnostico etiologico oportuno y el tratamiento apropiado permiten el control adecuado de su sintomatologia y, potencialmente, su curacion definitiva.

Publication types

  • Case Reports

MeSH terms

  • Albendazole / therapeutic use
  • Anomia / drug therapy
  • Anomia / etiology*
  • Anthelmintics / therapeutic use
  • Anticonvulsants / therapeutic use
  • Antipsychotic Agents / therapeutic use
  • Carbamazepine / analogs & derivatives
  • Carbamazepine / therapeutic use
  • Citalopram / therapeutic use
  • Delayed Diagnosis
  • Depressive Disorder / drug therapy
  • Depressive Disorder / etiology
  • Drug Resistance
  • Drug Therapy, Combination
  • Epilepsy, Temporal Lobe / drug therapy
  • Epilepsy, Temporal Lobe / etiology*
  • Headache / etiology
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Neurocysticercosis / complications*
  • Neurocysticercosis / diagnosis
  • Neurocysticercosis / drug therapy
  • Neurocysticercosis / psychology
  • Oxcarbazepine
  • Panic Disorder / drug therapy
  • Panic Disorder / etiology*
  • Perphenazine / therapeutic use
  • Prednisone / therapeutic use

Substances

  • Anthelmintics
  • Anticonvulsants
  • Antipsychotic Agents
  • Citalopram
  • Carbamazepine
  • Albendazole
  • Perphenazine
  • Prednisone
  • Oxcarbazepine