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How Long Does It Take For Antiepileptics To Cure Neurocysticercosis?
Question: I have been diagnosed with neurocysticercocis for the past 3 years. I was on Albendazole initially for 3 weeks and then have been on anti epileptics all throughout 3 years with varying degrees of dosage. In these 3 years I had 3 episodes of seizures and every time I would have to be admitted for a week n greenbacks be on steroids to bring down the resulting edema along with the antiepileptics. every year an Mri would reveal that the number of lesions were less as compared.to previous but there are active ones too.
My neuro suggests that the natural body has a.tendency to fight back n slowly being on antiepileptics for a longer duration will bring down the number of lesions until they are wiped out. Scars would remain as calcified lesions.
Some other neuro says it's best to take another round of albendazole I.e under administration being admitted for 2 or 3 weeks cos there are still active lesions in your brain. I ask the risk level n they say yes it is risky cos I have a lot of lesions spread around in my brain. There could be seizures during the treatment n that's why we suggest to be admitted.
My neuro says this might lead to a.case if all are dying at the same instant the resulting edema or swelling on the brain could be a risk factor to play with n patients.can into coma also.
Kindly let.me.know your views.on this. ?
How many years generally does.it take for ncc to be cured completely if.I am only.on.antiepileptics?
Do the eggs or worms in the brain multiply?
I am really not.in a.state of.mind as this illness has been with me for so long already now. I am ready mentally to.fight it but need some clarity on best way to proceed further.
My neuro suggests that the natural body has a.tendency to fight back n slowly being on antiepileptics for a longer duration will bring down the number of lesions until they are wiped out. Scars would remain as calcified lesions.
Some other neuro says it's best to take another round of albendazole I.e under administration being admitted for 2 or 3 weeks cos there are still active lesions in your brain. I ask the risk level n they say yes it is risky cos I have a lot of lesions spread around in my brain. There could be seizures during the treatment n that's why we suggest to be admitted.
My neuro says this might lead to a.case if all are dying at the same instant the resulting edema or swelling on the brain could be a risk factor to play with n patients.can into coma also.
Kindly let.me.know your views.on this. ?
How many years generally does.it take for ncc to be cured completely if.I am only.on.antiepileptics?
Do the eggs or worms in the brain multiply?
I am really not.in a.state of.mind as this illness has been with me for so long already now. I am ready mentally to.fight it but need some clarity on best way to proceed further.
Brief Answer:
You need to continue antiepileptics to control seizure
Detailed Answer:
Hi XXXX,
Thanks for writing in to us.
I have read through your query in detail.
Please find my observations below.
1. It is possible that 3 years back you had multiple lesions in your brain due to neurocysticercosis infection. These lesions are in multiple stages from egg larva and cystic to calcified granuloma. The calcified granuloma is the healed stage and the cystic is the one that causes release of toxins.
2. Seizures are more frequently associated with cystic stage and less frequently seen with calcified granuloma.
3. Seizures happen due to abnormal electric current in the brain. This occurs when the cystic stage releases toxins and also rarely due to granuloma. If there are a large number of cystic stage lesions then the chance of release of toxins is higher and seizures might be for longer duration and more often. Taking anti epileptic medicine increases the brain threshold for seizure activity and stops seizures from happening.
4. If there are cystic stage lesions then you should observe food hygiene and take albendazole for a week if you still have cystic stage lesion in brain. This will control multiplication of the cysts and control the infection. Antiepileptics should be continued to control seizures.
5. I have seen hundreds of patients coming to me with neurocysticercosis and usually patients improve over 3 to 5 years. In most of them the patient does not have seizures for more than 2 years. Total disappearance of the infection might take 5 to 10 years and in some the calcified granuloma might persist for life time.
6. Anti epileptics should be continued as directed by your doctor and this is to prevent seizures.
7. The cysts are live and might multiply if not treated with albendazole but the calcified granuloma will not multiply because they are healed.
Hope this answers your question. Please feel free to correct any oversight in my interpretation of your problems and discuss them in detail as per your requirements.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
You need to continue antiepileptics to control seizure
Detailed Answer:
Hi XXXX,
Thanks for writing in to us.
I have read through your query in detail.
Please find my observations below.
1. It is possible that 3 years back you had multiple lesions in your brain due to neurocysticercosis infection. These lesions are in multiple stages from egg larva and cystic to calcified granuloma. The calcified granuloma is the healed stage and the cystic is the one that causes release of toxins.
2. Seizures are more frequently associated with cystic stage and less frequently seen with calcified granuloma.
3. Seizures happen due to abnormal electric current in the brain. This occurs when the cystic stage releases toxins and also rarely due to granuloma. If there are a large number of cystic stage lesions then the chance of release of toxins is higher and seizures might be for longer duration and more often. Taking anti epileptic medicine increases the brain threshold for seizure activity and stops seizures from happening.
4. If there are cystic stage lesions then you should observe food hygiene and take albendazole for a week if you still have cystic stage lesion in brain. This will control multiplication of the cysts and control the infection. Antiepileptics should be continued to control seizures.
5. I have seen hundreds of patients coming to me with neurocysticercosis and usually patients improve over 3 to 5 years. In most of them the patient does not have seizures for more than 2 years. Total disappearance of the infection might take 5 to 10 years and in some the calcified granuloma might persist for life time.
6. Anti epileptics should be continued as directed by your doctor and this is to prevent seizures.
7. The cysts are live and might multiply if not treated with albendazole but the calcified granuloma will not multiply because they are healed.
Hope this answers your question. Please feel free to correct any oversight in my interpretation of your problems and discuss them in detail as per your requirements.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
thanks for your response ... gave me a good idea on the way it works ... i am attaching the mri report and few random soft copy scans of the most recent seiZure that I had a month ago.... these are.the medications I am currently on post he seiZure ... levipil 2500mg epsolin 200mg Tegretal 800mg lobazam 10mg dexona 2mg and panto .... full day dosage ... I have been told there is a lot of edema and I'll have to be on steroids for a.long time to let it come.down...the extent of meds makes me drowsy most of the day .. Please let me.know what do you see from.the.scans? how many active cysts do you see? what are the risks of going in for an AlbendaZole treatment? ... does the Albendazole treatment kill all the active ones ? ... you haven't told me if the.natural body has a tendency to kill the active cysts without any deworming treatment and only.taking antiepileptics for a long period of time?
Brief Answer:
Please find details below
Detailed Answer:
Hi XXXX,
Thanks for writing back with an update.
1. The reports show that there are multiple cystic and active lesions in your brain. They might be more than 10 to 20 in number. This is a large number and therefore you have to take treatment as recommended.
2. Treatment involves the antiepileptic and steroid to reduce brain swelling and seizure tendency. Since active lesions are present therefore it will be better to take a course of albendazole which will control the infection.
3. Taking albendazole will kill all the active ones and cause rupture of the cysts and that might release toxins in the brain. There is a possibility of seizures happening at that time and you should take steroids to avoid them.
4. It is true that the medicines make you drowsy but there is lot of infection and stopping medicine might cause non stop seizures and that will be a risky situation.
5. The natural immunity in the body cannot kill all the cysts in your case and medicine is required. Antiepileptic is important for a long time and you should avoid activities like driving, cooking, swimming and working with heavy machinery.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
Please find details below
Detailed Answer:
Hi XXXX,
Thanks for writing back with an update.
1. The reports show that there are multiple cystic and active lesions in your brain. They might be more than 10 to 20 in number. This is a large number and therefore you have to take treatment as recommended.
2. Treatment involves the antiepileptic and steroid to reduce brain swelling and seizure tendency. Since active lesions are present therefore it will be better to take a course of albendazole which will control the infection.
3. Taking albendazole will kill all the active ones and cause rupture of the cysts and that might release toxins in the brain. There is a possibility of seizures happening at that time and you should take steroids to avoid them.
4. It is true that the medicines make you drowsy but there is lot of infection and stopping medicine might cause non stop seizures and that will be a risky situation.
5. The natural immunity in the body cannot kill all the cysts in your case and medicine is required. Antiepileptic is important for a long time and you should avoid activities like driving, cooking, swimming and working with heavy machinery.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thanks for your detailed response. Had a few more.add.on.queries.
Does this illness affect memory in the long run? What add on techniques would you suggest to assist in the healing process? Like are yoga n meditation helpful ? can Any herbal massage be taken to help in calming the mind ?
Does it affect immunity? I ask this cos I have come to realise my immunity is not as same as before and also my motions don't get cleared in one session. 2 or 3 sessions it takes sometimes to clear my bowels on the morning. I work in the it industry and I use the comp. Earlier I could use the comp for longer periods. Now I can't look at the comp screen for too long. I feel sleepy. Any specific diet that you would suggest to avoid? Any home remedies that can assist? I am sorry m asking a lot of questions. I am just trying to ensure I am able to fight this illness in all possible ways. It has really started affecting me mentally. Minds always filled with thoughts. Doc has told me to remain as relaxed as.possible and not to stress myself out. I am trying but it's getting difficult. I fear.to eat out. Only eat hygienic home cooked food. Have to travel in public transport. Cannot work for 8 hours a day. after few hours I feel hazy.
Does this illness affect memory in the long run? What add on techniques would you suggest to assist in the healing process? Like are yoga n meditation helpful ? can Any herbal massage be taken to help in calming the mind ?
Does it affect immunity? I ask this cos I have come to realise my immunity is not as same as before and also my motions don't get cleared in one session. 2 or 3 sessions it takes sometimes to clear my bowels on the morning. I work in the it industry and I use the comp. Earlier I could use the comp for longer periods. Now I can't look at the comp screen for too long. I feel sleepy. Any specific diet that you would suggest to avoid? Any home remedies that can assist? I am sorry m asking a lot of questions. I am just trying to ensure I am able to fight this illness in all possible ways. It has really started affecting me mentally. Minds always filled with thoughts. Doc has told me to remain as relaxed as.possible and not to stress myself out. I am trying but it's getting difficult. I fear.to eat out. Only eat hygienic home cooked food. Have to travel in public transport. Cannot work for 8 hours a day. after few hours I feel hazy.
Brief Answer:
Please take precautions and be relaxed
Detailed Answer:
Hi XXXX,
Thanks for writing back with an update.
1. It is important to eat clean hygienic food and wash your hands before eating. You are doing this and it is the correct thing.
2. Meditation helps to reduce stress and also brings harmony. Doing 30 minutes meditation every day in the morning will help start your day better.
3. Avoid eating raw food and salad. The food you eat must be cooked properly. Non vegetarian food is best cooked in pressure cooker.
4. Memory is unlikely to get involved in most people. However if there is infection in higher centers of brain then it can cause such symptoms but this is not common.
5. Taking steroids will decrease your immunity and you should be careful during the time you are on steroids. Do not expose yourself to dust and pollution. Take regular break when doing work and drink fresh juices and eat fruits which are washed. Eating unwashed fruits and vegetables is to be avoided.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
Please take precautions and be relaxed
Detailed Answer:
Hi XXXX,
Thanks for writing back with an update.
1. It is important to eat clean hygienic food and wash your hands before eating. You are doing this and it is the correct thing.
2. Meditation helps to reduce stress and also brings harmony. Doing 30 minutes meditation every day in the morning will help start your day better.
3. Avoid eating raw food and salad. The food you eat must be cooked properly. Non vegetarian food is best cooked in pressure cooker.
4. Memory is unlikely to get involved in most people. However if there is infection in higher centers of brain then it can cause such symptoms but this is not common.
5. Taking steroids will decrease your immunity and you should be careful during the time you are on steroids. Do not expose yourself to dust and pollution. Take regular break when doing work and drink fresh juices and eat fruits which are washed. Eating unwashed fruits and vegetables is to be avoided.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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