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Singh M, Sharma M, Chaurasia S, Grewal AM, Kaur S, Kaur M, Yadav D, Gupta P. Ophthalmic presentations and long-term outcomes of subconjunctival and atypical orbital myocysticercosis. Indian J Ophthalmol 2021; 69:2782-2787. [PMID: 34571635 PMCID: PMC8597455 DOI: 10.4103/ijo.ijo_568_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 06/08/2021] [Accepted: 07/02/2021] [Indexed: 11/28/2022] Open
Abstract
PURPOSE To study the clinical presentation, radiological features, diagnosis, and treatment response in subconjunctival and atypical orbital myocysticercosis. METHODS Retrospective analysis of diagnosed subconjunctival and atypical (strabismus, diplopia, and blepharoptosis) orbital myocysticercosis was performed. A diagnostic criterion (2 of the 3) among clinical features, radiological findings, and treatment response was used in our study. A minimum of "post-treatment" follow-up of 12 months was observed. RESULTS Thirty-five patients were included with a mean age of 16 years having male predominance (n = 22, 62.8%). All had a unilateral presentation, with 24 (68.6%) patients having subconjunctival cysticercosis, of which 22 were located in close proximity of the rectus muscle insertion. At presentation, 10 patients had diplopia, 7 had strabismus, and 6 had face turn. Pseudo Duane's and pseudo-Brown's syndrome were noted in 5 and 4 patients, respectively. Radiologically, single muscle myositis without scolex was seen in 12 (34.3%) cases. All patients first received medical treatment, and surgical intervention (cyst removal) was attempted after treatment failure. Complete resolution of symptoms was noted in 22 (after medical treatment only) and in 8 (after surgery). CONCLUSION In the majority, the subconjunctival cysticercosis is found in proximity to the rectus muscle insertion, as a part of orbital myocysticercosis. In atypical scenarios, a satisfactory response to medical treatment can be considered as diagnostic of cysticercosis.
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Affiliation(s)
- Manpreet Singh
- Department of Ophthalmology, Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Manjula Sharma
- Department of Ophthalmology, Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Shweta Chaurasia
- Department of Ophthalmology, Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Aditi Mehta Grewal
- Department of Ophthalmology, Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Savleen Kaur
- Department of Ophthalmology, Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Manpreet Kaur
- Department of Ophthalmology, Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Deepti Yadav
- Department of Ophthalmology, Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Pankaj Gupta
- Department of Ophthalmology, Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India
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Salim S, Alam MS, Backiavathy V, Raichura ND, Mukherjee B. Orbital cysticercosis: clinical features and management outcomes. Orbit 2021; 40:400-406. [PMID: 33107374 DOI: 10.1080/01676830.2020.1833942] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Accepted: 09/27/2020] [Indexed: 06/11/2023]
Abstract
AIM To describe the clinical and radiological features of orbital cysticercosis and its management outcome. MATERIAL AND METHOD A retrospective analysis of consecutive cases of orbital cysticercosis between January 2008 and January 2018. The management outcome was classified into good, fair, and poor depending upon the resolution of the clinical features and status of the cyst and scolex in the imaging studies. RESULTS A total of 61 patients with a mean age of 24.33± 31.04 years were included. The male: female ratio was 1.9:1. Pain, with or without prominence of the eye was the most common presenting symptom (n = 35, 57.4%). The mean duration of symptoms was 3.65 +/-8.56 months. Ocular motility restriction was the most common sign (n = 52, 85.2%). Fifty-five (90.16%) patients had myocysticercosis with inferior rectus being most commonly involved (n = 17, 27.9%), while 6 (9.83%) cases had orbital cysticercosis without any ocular muscle involvement. Four patients had compressive optic neuropathy. Subjectively, good clinical outcome was documented in 37 (60.65%), fair in 17 (27.87%) and poor in 7 (11.47%) patients. Objectively, imaging studies showed complete resolution of the cysticercosis lesion in 18 (45%), partial in 19 (47.5%), and no change in 3 (7.5%) patients. CONCLUSION A high index of suspicion and a thorough knowledge of the clinical and radiological features are necessary for the proper diagnosis and management of orbital cysticercosis. Medical management with oral albendazole combined with oral steroids leads to desired outcome in the majority.
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Affiliation(s)
- Shebin Salim
- Orbit, Oculoplasty, Reconstructive & Aesthetic Services, Sankara Nethralaya, Medical Research Foundation, Chennai, India
| | - Md Shahid Alam
- Orbit, Oculoplasty, Reconstructive & Aesthetic Services, Aditya Birla Sankara Nethralaya, Kolkata, India
- A Unit of Medical Research Foundation, Chennai, India
| | - Varsha Backiavathy
- Orbit, Oculoplasty, Reconstructive & Aesthetic Services, Sankara Nethralaya, Medical Research Foundation, Chennai, India
| | - Nirav Dilip Raichura
- Orbit, Oculoplasty, Reconstructive & Aesthetic Services, Sankara Nethralaya, Medical Research Foundation, Chennai, India
| | - Bipasha Mukherjee
- Orbit, Oculoplasty, Reconstructive & Aesthetic Services, Sankara Nethralaya, Medical Research Foundation, Chennai, India
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Pujari A, Bhaskaran K, Modaboyina S, Das D, Saluja G, Samdani A, Singh P, Bajaj MS, Sharma N. Cysticercosis in ophthalmology. Surv Ophthalmol 2021; 67:544-569. [PMID: 34339720 DOI: 10.1016/j.survophthal.2021.07.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 07/20/2021] [Accepted: 07/26/2021] [Indexed: 12/17/2022]
Abstract
Cysticercosis is caused by Taenia solium, a cestode or tapeworm that preferentially affects the subcutaneous tissue, brain, muscle, and the eye. It is traditionally a disease of low socioeconomic regions, but large-scale population migration has made it a matter of global concern. Its ocular invasion is a potentially blinding disease. In the last two decades, there has been considerable discussion of cysticercosis; however, most comes from a limited number of case observations. Thus, to overcome this limitation, we summarize and analyse twenty years of medical literature (from 2000 to 2020) on cysticercosis in ophthalmology.
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Affiliation(s)
- Amar Pujari
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, RPC-1, AIIMS, New Delhi, India.
| | - Karthika Bhaskaran
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, RPC-1, AIIMS, New Delhi, India
| | - Sujeeth Modaboyina
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, RPC-1, AIIMS, New Delhi, India
| | - Deepshekhar Das
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, RPC-1, AIIMS, New Delhi, India
| | - Gunjan Saluja
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, RPC-1, AIIMS, New Delhi, India
| | - Asha Samdani
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, RPC-1, AIIMS, New Delhi, India
| | - Pallavi Singh
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, RPC-1, AIIMS, New Delhi, India
| | - Mandeep S Bajaj
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, RPC-1, AIIMS, New Delhi, India
| | - Namrata Sharma
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, RPC-1, AIIMS, New Delhi, India
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Sharma A. Commentary: Modified intraocular lens injector assisted rescue technique for failed viscoexpression in a case of intracameral cysticercosis. Indian J Ophthalmol 2020; 68:934-935. [PMID: 32317497 PMCID: PMC7350453 DOI: 10.4103/ijo.ijo_2150_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Ashok Sharma
- Dr. Ashok Sharma's Cornea Centre, Chandigarh, India
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Patidar RK, Bhaskar S, Gosal JS, Garg M, Jha DK, Elhence P. Surgical Management of Extraocular Muscle Cysticercosis Causing Optic Foramen Syndrome. Asian J Neurosurg 2020; 15:165-167. [PMID: 32181194 PMCID: PMC7057861 DOI: 10.4103/ajns.ajns_280_19] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Accepted: 10/25/2019] [Indexed: 11/17/2022] Open
Abstract
Extraocular muscle cysticercosis usually presents with proptosis and restriction of eyeball movements. However, it can cause vision loss by compression of the optic nerve at the optic foramen in infrequent circumstances. We report a rare case with an unusual manifestation of ptosis, proptosis, lateral rectus palsy, and acute vision loss in the right eye. Magnetic resonance imaging was suggestive of cysticercal cyst. Emergency optic nerve decompression with cyst excision was done. Treatment of choice for extraocular muscle cysticercosis presenting with restriction of eyeball movements is mainly medical, consisting of albendazole and steroids. However, as this lesion rarely causes vision loss, indications of surgical decompression of optic nerve are not well defined. We recommend that early surgical management should be done along with medical treatment in cases of vision loss caused by extraocular muscle cysticercosis.
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Affiliation(s)
- Rajnish Kumar Patidar
- Department of Neurosurgery, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Suryanarayanan Bhaskar
- Department of Neurosurgery, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Jaskaran Singh Gosal
- Department of Neurosurgery, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Mayank Garg
- Department of Neurosurgery, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Deepak Kumar Jha
- Department of Neurosurgery, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Poonam Elhence
- Department of Pathology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
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Kaur S, Gupta P, Singh M, Kiran S, Goyal P. Cysticercosis of the superior oblique muscle of the eye. QJM 2019; 112:711-712. [PMID: 30859206 DOI: 10.1093/qjmed/hcz045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- S Kaur
- Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - P Gupta
- Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - M Singh
- Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - S Kiran
- Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - P Goyal
- Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India
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7
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Affiliation(s)
- Jyoti Matalia
- Pediatric Ophthalmology and Strabismology Services, Narayana Nethralaya, Narayana Health City, Bengaluru, Karnataka, India
| | - Shoruba Dinakaran
- Pediatric Ophthalmology and Strabismology Services, Narayana Nethralaya, Narayana Health City, Bengaluru, Karnataka, India
| | - Hemant Anaspure
- Pediatric Ophthalmology and Strabismology Services, Narayana Nethralaya, Narayana Health City, Bengaluru, Karnataka, India
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Prasad R, Bagri N, Mishra OP, Kumar Singh M. Proptosis of Eyeball in Children with Medial Rectus Cysticercosis: Report of 2 Cases. Eur J Ophthalmol 2018; 20:240-2. [DOI: 10.1177/112067211002000138] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Purpose To report 2 children with medial rectus cysticercosis presenting as proptosis of eyeball. Methods Case report. Results In orbital cysticercosis, extraocular muscle cysticercosis is the most common type. Two children, a 12-year-old girl and an 8 year-old boy, presented with proptosis and pain in the left eye. Both were diagnosed with medial rectus cysticercosis based on computed tomographic scan and serologic report and treated with oral albendazole and prednisolone without any residual ocular motility restriction. Conclusions We report 2 cases of medial rectus muscle enlargement caused by cysticercosis; describe its clinical importance, diagnosis, and treatment; and present a review of the literature.
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Affiliation(s)
- Rajniti Prasad
- Department of Pediatrics, Institute of Medical Sciences, Banaras Hindu University, Varanas
| | - Narendra Bagri
- Department of Pediatrics, Institute of Medical Sciences, Banaras Hindu University, Varanas
| | - Om Prakash Mishra
- Department of Pediatrics, Institute of Medical Sciences, Banaras Hindu University, Varanas
| | - Mahendra Kumar Singh
- Department of Ophthalmology, Institute of Medical Sciences, Banaras Hindu University, Varanasi - India
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Surve A, Goel S, Bajaj MS, Pujari A. Extraocular muscle cysticercosis: never skip steroids. BMJ Case Rep 2018; 2018:bcr-2017-223356. [PMID: 29321202 DOI: 10.1136/bcr-2017-223356] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Abhidnya Surve
- Department of Ophthalmology, Dr Rajendra Prasad Centre for Ophthalmic Sciences, AIIMS, New Delhi, India
| | - Siddhi Goel
- Department of Ophthalmology, Dr Rajendra Prasad Centre for Ophthalmic Sciences, AIIMS, New Delhi, India
| | - Mandeep S Bajaj
- Department of Ophthalmology, Dr Rajendra Prasad Centre for Ophthalmic Sciences, AIIMS, New Delhi, India
| | - Amar Pujari
- Department of Ophthalmology, Dr Rajendra Prasad Centre for Ophthalmic Sciences, AIIMS, New Delhi, India
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Dhiman R, Devi S, Duraipandi K, Chandra P, Vanathi M, Tandon R, Sen S. Cysticercosis of the eye. Int J Ophthalmol 2017; 10:1319-1324. [PMID: 28861361 DOI: 10.18240/ijo.2017.08.21] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2016] [Accepted: 05/16/2017] [Indexed: 11/23/2022] Open
Abstract
Cysticercosis is a preventable and eradicable cause of blindness endemic in the Indian subcontinent, South-East Asia and other developing countries. Ocular and orbital cysticercosis has varied presentations depending upon the site of involvement, number of lesion and the host immune response. In this article we present a review of the various clinical manifestations, diagnosis and management protocol for orbital and ocular cysticercosis. Owing to its varied presentation, cysticercosis may pose a diagnostic challenge to the health professionals. Early diagnosis and management can prevent the vision loss and optimize visual outcomes.
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Affiliation(s)
- Rebika Dhiman
- Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi 110029, India
| | - Saranya Devi
- Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi 110029, India
| | - Kavitha Duraipandi
- Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi 110029, India
| | - Parijat Chandra
- Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi 110029, India
| | - Murugesan Vanathi
- Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi 110029, India
| | - Radhika Tandon
- Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi 110029, India
| | - Seema Sen
- Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi 110029, India
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Verma S, Das AK, Pan S. Unusual presentations of extraocular cysticercosis: A clinical challenge to the ophthalmologists. Med J Armed Forces India 2015; 72:293-6. [PMID: 27546972 DOI: 10.1016/j.mjafi.2015.04.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2015] [Accepted: 04/17/2015] [Indexed: 11/24/2022] Open
Affiliation(s)
- Sudheer Verma
- Classified Specialist (Ophthalmology), 158 Base Hospital, C/O 99 APO, India
| | - A K Das
- Classified Specialist (Pathology), 158 Base Hospital, C/O 99 APO, India
| | - Somnath Pan
- Graded Specialist (Radiology), 164 Military Hospital, C/O 99 APO, India
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Verma R, Jaiswal A. Multiple brain parenchymal neurocysticercosis with extraocular muscle cysticercosis affecting levator palpebral superioris and superior rectus complex: an unusual association. BMJ Case Rep 2013; 2013:bcr-2012-007421. [PMID: 23355567 DOI: 10.1136/bcr-2012-007421] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
An 8-year-old girl presented to the neurology department with a complaint of insidious onset of left-sided ptosis and restricted elevation of the left eye. A CT scan orbit and brain revealed a ring-enhancing lesion in the levator palpebral superioris (LPS) and superior rectus (SR) muscle complex of the left eye and left parietal and right temporal region. She was started on steroid, followed by albendazole with improvement. The LPS/SR complex is the least common site of involvement among extraocular muscles in ocular cysticercosis. Specially, with brain neurocysticercosis (NCC), it is extremely rare. We report an unusual association of multiple brain NCC with ocular cysticercosis involving LPS and SR muscle.
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Affiliation(s)
- Rajesh Verma
- Department of Neurology, King George Medical University, Lucknow, Uttar Pradesh, India.
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Prabhakar S, Rangdal SS. Isolated Muscular Cysticercosis: A Rare Pseudotumor and Diagnostic Challenge, can It be treated Nonoperatively? A Report of Two Cases and Review of Literature. ACTA ACUST UNITED AC 2012. [DOI: 10.5005/jp-journals-10028-1011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
ABSTRACT
Cysticercosis, an infection with the larval form of pork tape worm, Taenia solium, commonly presents with multiple muscular cysts or CNS involvement. Due to vague clinical presentation and unfamiliarity of clinicians with this entity, it is difficult to diagnosis when seen as an isolated cyst. Traditional treatment is surgical excision and a course of deworming agents. We present two cases of isolated muscular cysticercosis diagnosed by USG, MRI and blood tests, who responded successfully to oral medication without need of operative intervention.
Case reports
A 45-year-old male patient had a tender 2 week swelling of 4 × 5 cm on medial right proximal calf. A 26-year male presented with discomfort and diffuse 6 cm swelling at inner left forearm. In both ultrasound showed characteristic hypoechoic cyst with hyperechoic scolex, and MRI revealed isolated cyst surrounded by inflamed muscles. FNAC confirmed cysticercosis, and the patient responded to oral albendazole (3 weeks) with oral steroids (2 weeks).
Conclusion
Although rare, possibility of isolated muscular cysticercosis should always be considered in any small musculoskeletal soft tissue swelling presenting with nonspecific clinical findings. Both our patients responded to medical therapy and were disease free, as confirmed at 3 months by follow-up MRI. These cysts can be confidently diagnosed on the basis of ultrasound and MRI, and can be very well-treated nonsurgically with an oral drug regimen consisting of albendazole and steroid.
How to cite this article
Rangdal SS, Prabhakar S, Dhatt S S, Prakash M, Dhillon MS. Isolated Muscular Cysticercosis: A Rare Pseudotumor and Diagnostic Challenge, can It be treated Nonoperatively? A Report of Two Cases and Review of Literature. J Postgrad Med Edu Res 2012;46(1):43-48.
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Chan EW, Looi A. Cysticercosis of the Levator Palpebrae Superioris. ANNALS OF THE ACADEMY OF MEDICINE, SINGAPORE 2010. [DOI: 10.47102/annals-acadmedsg.v39n12p938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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Yang HK, Kim CY, Hwang JM. Suprasellar Cysticercosis Associated With Partial Third Cranial Nerve Palsy Relieved by Surgical Cyst Removal. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2009. [DOI: 10.3341/jkos.2009.50.4.640] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- Hee Kyung Yang
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Chae-Yong Kim
- Department of Neurosurgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Jeong-Min Hwang
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
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Abstract
BACKGROUND Extraocular muscle cysticercosis is rare and can be classified based on the stage of evolution as viable, degenerating, and inactive. A tailored approach to therapy using a combination of albendazole and steroids has been proposed. In this study, we have evaluated the clinical features and response of "viable" extraocular muscle cysticercosis to a tailored therapy with oral albendazole and steroids. METHODS A retrospective review of 32 patients with viable extraocular muscle cysticercosis was performed over a 3-year period. Ultrasound examination was performed at 3 weeks and 6 weeks for resolution of the cyst and clinical signs following treatment with oral albendazole and prednisolone. The clinical presentation, ocular alignment, motility restriction, and ultrasound examination details were recorded on serial visits. RESULTS The mean age was 19.5 years. The most common presenting signs included limitation of ocular motility in 75%, conjunctival mass in 37.5%, diplopia in 28.1%, and proptosis in 28.1% of the patients, respectively. Ocular alignment evaluation revealed esotropia in 3.1%, exotropia in 12.5%, and hypertropia in 6.25%. Restriction of abduction and abduction in elevation was present in two patients each. The average time for complete resolution was 65.9 days. All the patients had resolution, except four, who had residual motility limitation but were asymptomatic. CONCLUSIONS Combination therapy with oral albendazole and steroids is effective in the management of viable extraocular muscle cysticercosis. However, residual motility restriction may persist despite treatment.
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Affiliation(s)
- Ramesh Murthy
- Pediatric Ophthalmology and Strabismus, LVPrasad Eye Institute, Hyderabad, India.
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Singh U, Gupta P, Bansal R. Unusual presentation of orbital cysticercosis in subperiosteal space. J Pediatr Ophthalmol Strabismus 2008; 45:379-80. [PMID: 19043954 DOI: 10.3928/01913913-20081101-14] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The authors describe a previously unreported case of subperiosteal orbital cysticercosis in a child. Surgical incision on the periosteum led to the extrusion of a cyst, which was confirmed histopathologically. Cysticercosis should also be considered in the differential diagnosis of subperiosteal abscess.
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Affiliation(s)
- Usha Singh
- Department of Ophthalmology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
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Sahu PS, Parija SC, Sahu PK. Tear IgA-ELISA: a novel and sensitive method for diagnosis of ophthalmic cysticercosis. Acta Trop 2008; 106:168-74. [PMID: 18462701 DOI: 10.1016/j.actatropica.2008.03.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2007] [Revised: 03/09/2008] [Accepted: 03/11/2008] [Indexed: 11/29/2022]
Abstract
For the first time, presence of locally secreted specific IgA antibodies in tear specimen from human with ophthalmic cysticercosis is documented in the present study. The ELISA using Taenia solium metacestode excretory secretory (ES) antigen demonstrated a diagnostic level of IgA antibodies in tears with 100% sensitivity (6 out of 6 confirmed cases of ophthalmic cysticercosis) whereas, 25 of 34 (73.52%) clinically suspected cases were diagnosed positive. The ELISA using T. solium metacestode somatic antigen detected a diagnostic titre of IgA antibody in tears with a sensitivity of 50% (3 out of 6 confirmed cases). The specificity of the tear IgAELISA using T. solium metacestode somatic and ES antigens is observed to be 94.87% and 92.3%, respectively. Overall in tears, the ELISA using T. solium metacestode ES antigens for detection of IgA antibodies shows a higher diagnostic efficiency (93.33%) compared to that using T. solium metacestode somatic antigen (88.88%). The sensitivities of the ELISA for detection of IgA antibodies in tears is observed to be higher than that for detection of IgG antibodies in serum using either somatic or ES antigens of the parasite.
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Affiliation(s)
- Priyadarshi S Sahu
- Department of Microbiology, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India.
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