NON-EPILEPTIC MANIFESTATIONS IN PATIENTS WITH SINGLE ENHANCING COMPUTED TOMOGRAPHY LESIONS IN A TERTIARY CARE CENTRE OF BIHAR
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2017, Vol 6, Issue 85
Abstract
BACKGROUND Single small ring enhancing computed tomography lesion is a clinicoradiological abnormality being reported more frequently as imaging of the brain becomes more prevalent. It is a common abnormality on imaging in young patients of low socioeconomic status presented with acute symptomatic seizures in tropical and developing countries like India. Neurocysticercosis and Tuberculoma are the commonest ring forming granulomas. Apart from the seizure, many varieties of other neurological manifestations have been observed in these cases of single ring enhancing lesions found on the computed tomography scan of brain. The objective of the present study is to identify the non-epileptic manifestations of single ring enhancing computed tomography lesions. MATERIALS AND METHODS This is a descriptive study conducted in Neurology Unit of Department of General Medicine, Patna Medical College and Hospital Patna, Bihar. A total of 52 patients of age group 20-60 years with acute onset non-epileptic disorder having symptoms and signs other than seizure as presenting complaint with no evidence of other associated systemic diseases were included. A detailed clinical history with thorough clinical examination along with haematological and biochemical parameters were obtained in all patients. All patients were subjected to non-contrast and contrast-enhanced computed tomography of brain at the time of initial evaluation and repeated after 8-12 weeks of duration. RESULTS Out of 52 patients, it was observed that prevalence of non-epileptic manifestations of single ring enhancing CT lesions were higher in younger age group with no gender predilection. Among the non-epileptic manifestations, headache with or without vomiting (19.23%) was the most common and hemiparesis (15.38%) either of left or right side was the second most common presentation followed by hemichorea (11.54%) and homonymous hemianopia (11.54%). The incidence of single ring enhancing lesion was more prevalent in patients belonging to low socioeconomic status. CONCLUSION Although seizure is the commonest presentation in patients with single ring enhancing lesion on computed tomography, the manifestations may vary. The heterogenous localisation of the parasite or bacteria in the brain, variable inflammatory responses in surrounding tissue and inconsistent natural history are responsible for pleomorphic manifestations of the disease.
Authors and Affiliations
Anuj Kumar, Jyoti Kumar Dinkar, Naresh Kumar
Keywords
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- EP ID EP277610
- DOI 10.14260/jemds/2017/1280
- Views 72
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