Short Course of Prednisolone in Indian Patients with Solitary Cysticercus Granuloma and New‐onset Seizures

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Abstract
Summary: Purpose: To evaluate the role of a short course of oral corticosteroids in Indian patients with solitary cysticercus granuloma with seizures. Methods: In this open‐label, randomized, prospective follow‐up study, 97 patients with new‐onset seizures and a single enhancing computed tomography (CT)‐detected lesion of cysticercosis were randomly divided in two groups to receive either antiepileptic monotherapy alone (n = 48) or antiepileptic monotherapy with prednisolone (n = 49). The patients in the latter group received prednisolone, 1 mg/kg/day for 10 days, followed by tapering over next 4 days. The patients were followed up for 6 months. Repeated CT scans were performed after 1 and 6 months. Results: The majority of patients were young. Simple partial seizure, with or without secondary generalization, was the commonest seizure type encountered. Follow‐up CT scans at 1 and 6 months demonstrated a significantly better response for prednisolone as far as complete resolution of CT lesion was concerned. Kaplan–Meier analysis suggested significantly less probability of seizure recurrence for prednisolone‐treated patients. At 6 months, Kaplan–Meier estimated risk of seizure after first seizure was 2% in prednisolone‐treated patients in comparison to 13% for those who were not given prednisolone. Conclusions: Short‐term prednisolone therapy helps in rapid resolution of solitary cysticercus granuloma in Indian patients with new‐onset seizures. Resolution of lesions is associated with improved seizure‐related prognosis.