Diagnosis and treatment of epilepsy secondary to cerebral sparganosis / 中华神经医学杂志

ABSTRACT

Objective:To explore the clinical characteristics, diagnostic methods, treatment strategies, and curative efficacies of epilepsy secondary to cerebral sparganosis.Methods:A retrospective analysis on clinical data of 62 patients with epilepsy caused by cerebral sparganosis diagnosed in our hospital from July 2004 to May 2019 was performed. According to the treatment intention of the patients, these patients were divided into surgery group ( n=39) and drug deworming group ( n=23). Patients in the surgery group were treated with craniotomy assisted by navigation to remove worms and lesions, and patients without live worms were treated with lesion resection or cortical burning. Patients in the drug deworming group were treated with praziquantel at a dose of 60 mg/(kg·d) with 10 d as a course of treatment; the next course of treatment was followed at an interval of 2 months, and ended until the standard of cure was achieved. All patients were followed up for 1-8 years, and the prognoses were determined according to the imaging data, clinical symptom improvement and sparganosis antibody IgG detection results. The epilepsy control 1 year after treatment was assessed by modified Engel grading. Results:Live worms were removed from 34 patients of the surgery group, with a total of 35 worms; after 1-8 years of follow-up, 34 patients were cured and 5 patients were not cured in the surgery group; however, 7 patients were cured and 16 patients were not cured in the drug deworming group; the cure rate in the surgery group was signficantly higher than that in the drug deworming group ( P=0.000). Modified Engel grading I was achieved in 36 patients, grading II in 2 patients, grading III in 0, and IV in 1 patient of the surgery group; modified Engel grading I was achieved in 9 patients, grading II in 3, grading III in 5, and grading IV in 6 patients of the drug deworming group; significant differences were noted between the two groups ( Z=203.000, P=0.000); the mean rank suggested that the surgery group had better efficacy than the drug deworming group(25.21 vs. 42.17). Conclusion:The successful surgical removal of live worms with the help of modern neurosurgery technology has better efficacy than drug deworming treatment in the epilepsy secondary to cerebral sparganosis.