Diagnostic Dilemma - Pediatric Oncall
Neurocysticercosis or tuberculoma
Author: Pediatric Oncall
An 8 years old girl had a right sided focal convulsion 5 months back. MRI brain at that time was suggestive of well defined ring enhancing. T2 hyperintense conglomerate lesions in left high parietal region with surrounding perilesional edema {1.2 x 1cm} suggestive of neurocysticercosis. She was given Albendazole for 28 days and steroids in tapering doses. She was continued on Carbamazepine. She was alright for next 3 months when she again had a focal convulsion. At that time MRI showed same size lesion with no change as compared to previous scan. She had no other complaints and contact with TB was not present. Her CSF was normal, CSF TB PCR was negative, Chest X-Ray and Mantoux test were negative. Her blood cysticercus IgG was negative. She was started on 4 drug AKT in view of persistent granuloma. Currently the child has completed 2 months of ATT and is otherwise asymptomatic.
Answers of this discussion
Author :- MANISH AGRAWAL on 23 November 2011.
Answer :- I still think she is a case of NCC.

Author :- Cristina Marzal on 24 November 2011.
Answer :- Tuberculoma

Author :- amanyameenaly on 24 November 2011.
Answer :- Neurocycticercosis may appear closer to right answer. But -ve chest X-ray and normal csf do not exclude tuberculoma.Biopsy of lesion can give an answer.But as pediatrician i never advice that.Follow up and and anticonvulsive therapy are quite sufficient for the girl .

Author :- Abhanucash on 24 November 2011.
Answer :- treated ncc,scar epilepsy.

Author :- Ravi Parihar on 24 November 2011.
Answer :- ist diagnosis is ncc

Author :- yousef ahmed on 25 November 2011.
Answer :- Tuberculoma

Author :- jayesh solanki on 30 November 2011.
Answer :- tuberculoma

Author :- sarah Ashour on 30 November 2011.
Answer :- tuberculoma

Author :- tin sweayec on 30 November 2011.
Answer :- Neurocysticercosis

Author :- drbharat bansal on 30 November 2011.
Answer :- neurocyscticercosis

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