Poster Abstracts Thursday, November 10, 2005 $469

EL-Senousey MY 1, Nassar H ~, Morad M ~, EL Kala F 3. 1Department of Neurology, Tanta University, Egypt; 2Department of Clinical Pathology, Tanta University, Egypt; 3Department of Tropical Medicine, Tanta University, Egypt

Hepatitis C virus (HCV) is a national health disaster in Egypt. Surprisingly, the extra-hepatic manifestations including the neurolo- gical and psychiatric ones, can constitute the earliest presenting manifestations of the disease. The aim of this work is to study the neurological and behavioural complications related to HCV infection using clinical, laboratory and neurophysiological methods and to study the possible role of inmmne mechanisms in the pathogenesis of these complications. This study is a cross-sectional, patient-control study and was conducted over 4 stages. Neuropsychiatric complica- tions were present in 47.1% of patients. Neurological and Psychiatric symptoms were initial in 7.7"/0 and 4.8%, respectively. The develop- ment of Neuropsyctfiatric complications were not correlated with the age of the patient, the duration of HCV or severity of the liver disease. Neuropathy was the most common neurological compli- cation (28.8%), most of them were sensory mxonal. On the other hand, depression was the commonest psychiatric manifestation (26%), most of them had severe depression. Erythrocyte sedimentation rate, serum alalfine transferase and serum complement C3 level could not be correlated with the presence of neurological or psychiatric manifesta- tions. The presence of mixed cryglobulinemia and diminished serum complement C4 level correlated with the presence of neurological manifestations.

1455 Short course of Prednisolone in patients with solitary Cysticereus Ggranuloma: a double blind placebo controlled study

Garg, RK 1, Potluri, N 1, Kar, AM 1. 1Department of Neurology, King George's Medical University, Lucknow, India

The study was conducted to confirm the role of a short course of oral corticosteroids in patients with solitary cysticercus granuloma with seizures by a double-blind placebo-controlled study. In an open-label trial we, in past, had demonstrated a beneficial role of prednisolone. A short course of prednisolone helped in early resolution of solitary cysticercus granuloma. In this double-blind placebo-controlled randomized study, 60 patients with new-onset seizures and a single enhancing computed tomography (CT)-detected lesion of cysticercosis were randomly divided in two groups to receive either antiepileptic monotherapy with prednisolone (in -- 30) or antiepileptic monotherapy along with placebo (n - 30). The patients received prednisolone, 1 mg/ kg/day for 10 days, followed by tapering over next 4 days. None of the patients received albendazole therapy. The patients were followed up at least for 9 months. A repeat CT scan was performed after 6 months. The data were analyzed by Chi-Square test. The majority of patients were young. Simple partial seizure, with or without secondary generalization, was the commonest seizure type encountered. Follow- up CT scans at 6 months demonstrated an insignificantly better response for prednisolone treated patients. In prednisolone group the lesion was disappeared in 52% of patients while in 48"/0 patients who received placebo. However, a significantly lesser number of predniso- lone treated patients 0 a - 12%) than controls 0 a - 48%), had seizure recurrence. Our study suggests that short-term prednisolone therapy may not help in rapid resolution of solitary cysticercas granuloma, however, prednisolone therapy improves seizure-related prognosis.

1456 Solitary Cys~ticercus Granuloma: can antiepilepfic drug be withdrawn after lesion has disappeared?

Garg, RK 1, Singh, M K 1, Shukla, R 1, Kar, AM 1, Agarwal, A 1. ~Department Of Neurology, King George's Medical University, Lucknow, India

In this open-label randomized study, the effect of albendazole on resolution of cysricercus granuloma was observed. In second part of tire study, the patients who had complete resolution of tire lesions were again randomized with tire purpose to decide whether antiepileptic drug could be withdrawu after follow up CT Scan had become nomtal. The study included 70 consecutive patients with single enhancing CT lesions and new-onset seizures. All patients fulfilled the diagnostic criteria of solitary cysticercus granuloma. Patients were randomized to receive either albendazole and antiepileptic drug (AED) monotherapy (37) or AED alone (33 patients). All patients were followed-up at fortnightly interval for 2 months and then monthly intervals for minimum of 9 months. A follow-up CT Scan was performed after 3 months. In 49 patients who had complete resolution of solitary cysticercus granuloma were again randomized in two groups. In one group (27 patients) AED was tapered off, and remaining 22 patients continued AED monotherapy mfinterrupted. In first part o f the study, 27 (73%) patients receiving albendazole and 22 (67"/0) patients who did not receive albendazole had complete resolution of solitary cysricercus granuloma. The difference was statistically insignificant (i>0.05). In second part o f the study, only in one patient, of the group in which atttiepileptic drug was tapered off, had recurrence of seizure and needed reinstitution of the AED. Albendazole had no significant effect on resolution of solitary cysticercus granuloma. CT lesions are likely to resolve spontaneously. Antiepileptic drug can safely be withdrawn after CT lesion has disappeared.

1457 A survey on Neurological complaints in an urban prhnary care unit, Brazil

Hernamlez Fustes, 01, MmfllOZ, R z, Ribas, C 3. llnNeuro, Hospital Pilar, UTP, Curitiba, Brazil," ~Hospital University Cajuru, Brazil," SUFPR, Brazil

Objectives: To provide directions to the clinician regarding the com- monest neurological complaints in primary health care, we performed a survey with 399 adults in a primary care maJt in Curitiba, PR, Brazil. Methods: Patients were evaluated by a questionnaire including specific complaints. Results: Those related to the respiratory system were the most frequent (22, 8%), followed by the neurological (117, 5%), musculoskeletal (16, 8%) and gastrointestinal (12, 8%) among others. Those regarding the nervous system were headache (154, 3%), vertigo (20%), tinnitus (10%), depression/amxiety (18, 6?,';), among others. Conclusions: We did not evaluate diagnosis since complaints point to several differential diagnoses that have to be excluded. Facing the fiequency in which clinicians come across neurological complaints, kimwledge of basic sentiology and the initial management of patients with neurological complaints are essential. Therefore we aim at guiding the approach of the teaching neurologist in the pursuit of a better integration between basic science, semiology and clinical neurology towards providing the future professional with skills that will supply the basic needs of the conmmnity in primary practice.

1458 Thalanfie Pain for Neurocysficercosis

Hernandez Fustes, 01, Munhoz, R 2. llnNeuro, Hospital Pilaf, UT, Curitiba, Brazil," ~Hospita[ Univ Cajuru, Brazil

Introduction: Near the turn of the last century, Dejerine and Roussy reported and unusual kind of pain accompattied by other sensory and motor features, naming it as the Le syndrome thalamique. Riddoch named it Central Pain in 1938. Clinically it can be characterized by the sensory spectrum consists initially of contralateral hemisensory loss of both superficial and profound sensation. It affects the mucous membranes, is accompattied by astereoguosia and occasionally affects only pain and temperature or vibration and joint position sense. Patients describe the pain as tight, drawing, icy, and kitifelike.