Abstract：
BACKGROUND: The current study estimated incident breakthrough seizures, serum matrix metalloproteinase-9 (MMP-9), and perfusion magnetic resonance imaging (MRI) parameters in five- to 18-year-olds with neurocysticercosis (NCC) from colloidal or vesicular through calcified stages over at least 24 months\' follow-up.
METHODS: Single, colloidal, or vesicular parenchymal NCC cases were treated with albendazole and steroids and followed at a tertiary care north Indian hospital. Serum MMP-9 was estimated in colloidal or vesicular treatment-naive state and in a subset of calcified cases at six-month follow-up. The same subset of calcified cases also underwent perfusion MRI of the brain at six-month follow-up.
RESULTS: Among 70 cases, 70% calcified at six-month follow-up. Over a median follow-up of 30 months, the incidence of breakthrough seizures was 48.6% (61.2% in calcified and 19.2% in resolved, P = 0.001; 32.9% early [within six months] and 15.7% late [beyond six months], P = 0.02). Serum MMP-9 levels were higher in colloidal and vesicular compared with calcified stage (242.5 vs 159.8 ng/mL, P = 0.007); however, there was no significant association with breakthrough seizures and/or calcification in follow-up. In a subgroup of calcified cases (n = 31), the median relative cerebral blood volume on perfusion MRI in and around the lesion was lower in those with seizures (n = 12) than in those without (n = 19) (10.7 vs 25.2 mL/100 g, P = 0.05).
CONCLUSIONS: In post-treatment colloidal or vesicular NCC, incident breakthrough seizures decrease beyond six months. In calcified NCC with remote breakthrough seizures, significant perilesional hypoperfusion is seen compared with those without seizures.
METHODS: Single, colloidal, or vesicular parenchymal NCC cases were treated with albendazole and steroids and followed at a tertiary care north Indian hospital. Serum MMP-9 was estimated in colloidal or vesicular treatment-naive state and in a subset of calcified cases at six-month follow-up. The same subset of calcified cases also underwent perfusion MRI of the brain at six-month follow-up.
RESULTS: Among 70 cases, 70% calcified at six-month follow-up. Over a median follow-up of 30 months, the incidence of breakthrough seizures was 48.6% (61.2% in calcified and 19.2% in resolved, P = 0.001; 32.9% early [within six months] and 15.7% late [beyond six months], P = 0.02). Serum MMP-9 levels were higher in colloidal and vesicular compared with calcified stage (242.5 vs 159.8 ng/mL, P = 0.007); however, there was no significant association with breakthrough seizures and/or calcification in follow-up. In a subgroup of calcified cases (n = 31), the median relative cerebral blood volume on perfusion MRI in and around the lesion was lower in those with seizures (n = 12) than in those without (n = 19) (10.7 vs 25.2 mL/100 g, P = 0.05).
CONCLUSIONS: In post-treatment colloidal or vesicular NCC, incident breakthrough seizures decrease beyond six months. In calcified NCC with remote breakthrough seizures, significant perilesional hypoperfusion is seen compared with those without seizures.
摘要：
背景：当前的研究估计了突发性癫痫发作，血清基质金属蛋白酶-9(MMP-9),在至少24个月的随访中，5至18岁的神经囊虫病（NCC）患者从胶体或囊泡到钙化阶段的灌注磁共振成像（MRI）参数。
方法：单一，胶体，或囊泡实质性NCC病例接受阿苯达唑和类固醇治疗，并在印度北部的一家三级医院接受随访。在六个月的随访中，在胶体或囊泡治疗初期状态以及一部分钙化病例中估计了血清MMP-9。在6个月的随访中，相同的钙化病例也进行了脑灌注MRI检查。
结果：70例，在6个月的随访中，有70%钙化。经过30个月的中位随访，突破性癫痫的发生率为48.6%(钙化率为61.2%，消退率为19.2%，P=0.001；提前[六个月内]为32.9%，晚[六个月后]为15.7%，P=0.02)。与钙化期相比，胶体和囊泡中的血清MMP-9水平更高（242.5比159.8ng/mL，P=0.007)；然而，随访中与突破性惊厥和/或钙化无显著关联.在钙化病例亚组(n=31)中，有癫痫发作的患者（n=12）在病灶内和周围的灌注MRI上的相对脑血容量中位数低于没有癫痫发作的患者（n=19）（10.7vs25.2mL/100g，P=0.05)。
结论：在治疗后的胶体或囊泡NCC中，突发性癫痫发作减少超过六个月。在钙化的NCC伴远程突破性癫痫发作中，与没有癫痫发作的患者相比，可见明显的病灶周围灌注不足。
方法：单一，胶体，或囊泡实质性NCC病例接受阿苯达唑和类固醇治疗，并在印度北部的一家三级医院接受随访。在六个月的随访中，在胶体或囊泡治疗初期状态以及一部分钙化病例中估计了血清MMP-9。在6个月的随访中，相同的钙化病例也进行了脑灌注MRI检查。
结果：70例，在6个月的随访中，有70%钙化。经过30个月的中位随访，突破性癫痫的发生率为48.6%(钙化率为61.2%，消退率为19.2%，P=0.001；提前[六个月内]为32.9%，晚[六个月后]为15.7%，P=0.02)。与钙化期相比，胶体和囊泡中的血清MMP-9水平更高（242.5比159.8ng/mL，P=0.007)；然而，随访中与突破性惊厥和/或钙化无显著关联.在钙化病例亚组(n=31)中，有癫痫发作的患者（n=12）在病灶内和周围的灌注MRI上的相对脑血容量中位数低于没有癫痫发作的患者（n=19）（10.7vs25.2mL/100g，P=0.05)。
结论：在治疗后的胶体或囊泡NCC中，突发性癫痫发作减少超过六个月。在钙化的NCC伴远程突破性癫痫发作中，与没有癫痫发作的患者相比，可见明显的病灶周围灌注不足。
