Solitary cysticercus granuloma

Abstract

Solitary cysticercus granuloma is considered the most frequent type of neurocysticercosis in India and many other southeast Asian countries. It has frequently been reported from developed countries in immigrant populations. Genetic susceptibility has recently been linked with Toll-like receptor gene polymorphisms. These lesions are the most frequent neuroimaging abnormality seen in patients with new-onset epilepsy. Solitary cysticercus granuloma is seen on a contrast computed tomography as an enhancing ring-shaped lesion. These enhancing lesions are usually less than 20 mm in diameter and are surrounded by a varying amount of perilesional vasogenic edema. A variety of infectious, neoplastic, inflammatory or vascular diseases can manifest with a single ring-enhancing lesion of the brain, and differential diagnosis may be challenging. The most difficult differential diagnosis is small intracranial tuberculoma. Immunodiagnosis is often not helpful in the patients with single lesions. Antiepileptic treatment is the most important option. Albendazole and corticosteroids are of questionable value. Prognosis is generally good. Antiepileptic therapy can be withdrawn after disappearance of the lesion. Calcification of the lesion and perilesional gliosis may be responsible for frequent seizure recurrences.