Cerebral toxocariasis: a possible cause of epileptic seizure in children

Introduction: Toxocariasis is a worldwide human helminthiasis, which is mostly asymptomatic and caused by toxocara canis, a roundworm in dogs. These can cause visceral larva migrans syndrome in humans who ingest contaminated soil. CNS manifestation with a focal mass lesion is very rare, seizures often being the first symptom. Case report: We describe an 11-year-old girl presenting with a generalized epileptic seizure and eosinophilia in blood. Under antibiotic therapy under the assumption of toxoplasmosis the lesion did not decrease and surgical resection was considered. We used computer-assisted surgery (CAS) for careful tissue resection. Postoperatively the diagnosis of toxocariasis was confirmed and albendozole medication was administered for 7days. The patient developed well without neurological deficits or seizures. Conclusion: We conclude that although neurological involvement is rare in toxocariasis, a cerebral infection in a child with epileptic seizures and eosinophilia should be considere

Therapeutic strategies and management of desmoplastic infantile ganglioglioma: two case reports and literature overview

Introduction: Desmoplastic infantile gangliogliomas (DIG) are rare cerebral glioneural tumors usually occurring in early childhood. DIGs are generally benign although rare cases with poor outcome are known. Total resection, if possible, is the treatment of choice, without further adjuvant therapy. After incomplete resection, adjuvant chemo-and/or radiotherapy is generally applied, despite the potential negative side effects in such young patients. Case reports: We describe two girls with DIG, one who twice underwent subtotal resection at 3 and 5months, the other who underwent total resection at 2years. Neither had adjuvant therapy and there was no tumor recurrence. Conclusions: Our own experience and a review of the literature suggest that in most DIGs adjuvant therapy is not justified even after incomplete resection. After tumor recurrence a second surgical intervention should be considered instead of adjuvant therapy. An exception may be made for rare, deep-seated DIGs, which are more aggressive and have a poorer outcom

Penetration of rifampicin into the brain tissue and cerebral extracellular space of rats

Rifampicin is used to treat neurosurgical shunt infections because of its excellent in-vitro activity against staphylococci and its adequate penetration into the CSF. However, nothing is known about rifampicin concentrations in the cerebral extracellular space (CES). We measured the penetration of rifampicin into the CES of anaesthetized rats by microdialysis using low-flow and equilibrium methods. Depending on the method, rifampicin concentrations in the CES were 0·3-1% of the serum concentration or 3-8% of brain tissue concentration, respectively. These experimental data in animals suggest that the recommended dose of rifampicin in man might be inadequate for treatment of some brain infection