Acta Medica Lituanica最新文献

{"title":"Aprepitant versus Olanzapine in Patients of Breast Cancer on Adriamycin and Cyclophosphamide Regimen - Role in Effectiveness of Prevention of Nausea and Vomiting.","authors":"Indrani Devi Sarma, Sukainnya Buragohain, Joonmoni Lahon, Indrani Bhagawati, Neelakshi Mahanta, Dibyajyoti Saikia","doi":"10.15388/Amed.2025.32.1.22","DOIUrl":"10.15388/Amed.2025.32.1.22","url":null,"abstract":"<p><strong>Background: </strong>Chemotherapy-induced nausea and vomiting (CINV) is a significant concern for patients undergoing highly emetogenic chemotherapy (HEC). This study compares the efficacy of aprepitant and olanzapine in preventing CINV in breast cancer patients receiving Adriamycin and Cyclophosphamide (AC).</p><p><strong>Methods: </strong>A prospective, comparative, observational study was conducted over one year at the State Cancer Institute, Guwahati, India. 103 chemotherapy-naïve breast cancer patients were enrolled and divided into two groups: aprepitant and olanzapine, both receiving standard therapy with ondansetron and dexamethasone. CINV outcomes were assessed using the Multinational Association of Supportive Care in Cancer (MASCC) Antiemesis Tool over five days post-chemotherapy. Acute (0-24 hours) and delayed (24-120 hours) nausea and vomiting were evaluated. Side effects were documented and compared between groups.</p><p><strong>Results: </strong>Olanzapine demonstrated significantly better control of acute nausea compared to aprepitant (<i>p</i> < 0.05). It also showed a trend towards superior efficacy in delayed nausea, though statistical significance was not reached. There was no significant difference between aprepitant and olanzapine in preventing acute or delayed vomiting. The olanzapine group experienced more frequent side effects, but the difference was statistically insignificant.</p><p><strong>Conclusion: </strong>Olanzapine exhibited greater efficacy in preventing nausea, particularly in the acute phase, compared to aprepitant. However, its higher side effect profile suggests that careful patient selection is necessary. Both agents remain effective options for CINV management, with olanzapine offering an advantage in nausea prevention.</p>","PeriodicalId":34365,"journal":{"name":"Acta Medica Lituanica","volume":"32 1","pages":"118-119"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12239174/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144609805","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic Challenges in Lymphangioleiomyomatosis: From Ovarian Mass to Systemic Diagnosis.","authors":"Neringa Jansevičiūtė, Linas Andreika","doi":"10.15388/Amed.2025.32.1.19","DOIUrl":"10.15388/Amed.2025.32.1.19","url":null,"abstract":"<p><strong>Background: </strong><i>Lymphangioleiomyomatosis</i> (LAM) is a rare neoplastic disorder characterized by the proliferation of atypical smooth muscle-like or epithelioid cells within the lungs and axial lymphatic system. This pathological process leads to the formation of pulmonary cysts and impaired respiratory function. Although the disease primarily involves the lungs, extrapulmonary manifestations can occur in the abdominal cavity, lymphatic system, and retroperitoneum.</p><p><strong>Clinical case: </strong>A 48-year-old woman presented with abdominal numbness, leading to the discovery of a right ovarian mass. CT and MRI identified non-malignant solid mass in the ovary, as well as thin-walled cysts in the lungs, retroperitoneal pelvis, and upper abdomen, suggesting LAM. The patient was referred for pulmonology evaluation. Genetic testing and lung biopsy were inconclusive. One year later, during laparoscopic hysterectomy for early-stage uterine cancer, a biopsy of a left iliac lesion confirmed LAM. Postoperatively, the patient developed lymphocytic and chylous ascites, requiring further surgical intervention. However, the ascites recurred, and it was managed with diuretic therapy. Following the confirmed diagnosis, <i>Sirolimus</i> therapy was initiated. To date, the patient has not exhibited any significant respiratory symptoms, and follow-up lung imaging has shown no evidence of disease progression.</p><p><strong>Conclusions: </strong>Due to its rarity, diverse symptoms, and involvement of multiple organs, diagnosis of LAM is challenging. It requires careful clinical observation and a multidisciplinary approach. Early and accurate diagnosis, combined with timely therapeutic interventions, has the potential to significantly improve the patient outcomes in LAM.</p>","PeriodicalId":34365,"journal":{"name":"Acta Medica Lituanica","volume":"32 1","pages":"212-228"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12239191/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144609810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sudden Unexpected Death and Alcohol Addiction: Case Report on Disulfiram Use.","authors":"Gabija Kondratavičiūtė, Dalius Banionis, Sigitas Laima, Sigitas Chmieliauskas, Diana Vasiljevaitė, Paulius Petreikis, Robertas Badaras","doi":"10.15388/Amed.2025.32.1.5","DOIUrl":"10.15388/Amed.2025.32.1.5","url":null,"abstract":"<p><strong>Background: </strong><b>:</b> Disulfiram is a type of medication widely prescribed in order to cease alcohol consumption. When used with alcohol, the 'disulfiram-alcohol reaction' occurs, causing nausea and vomiting. Disulfiram blocks alcohol dissolving enzymes thus increasing acetaldehyde concentration and inducing the above-mentioned symptoms. These undesirable symptoms are similar to the side effects that occur to oncological patients after the administration of chemotherapy.</p><p><strong>Materials and methods: </strong><b>:</b> Descriptive research method was used. The literature focusing on alcohol, medications and drug consumption was reviewed.</p><p><strong>Case report: </strong><b>:</b> The primary abstinence at the beginning of treatment with <i>Disulfiram</i> does not guarantee that alcohol usage will not get manifested again at the further stages of treatment. Alcohol addiction forces patients to search for a way to avoid the unwanted reactions. Sometimes, patients tend to be quite ingenious while trying to suppress the arising side effects. In many cases, it involves the usage of additional medication.</p><p><strong>Conclusions: </strong><b>:</b> When alcohol addiction overpowers, the patient tries to reduce the undesirable symptoms and may even die if alcohol is combined with disulfiram. Death may occur due to the cardio and neurotoxic effects of acetaldehyde.</p>","PeriodicalId":34365,"journal":{"name":"Acta Medica Lituanica","volume":"32 1","pages":"153-159"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12239178/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144609837","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bilateral Inguinal Hernia Repair: Laparoscopic Totally Extraperitoneal Versus Open Lichtenstein.","authors":"Mykhaylo O Yosypenko, Oleg V Shulyarenko, Hryhorii O Havrylov","doi":"10.15388/Amed.2025.32.2.6","DOIUrl":"10.15388/Amed.2025.32.2.6","url":null,"abstract":"<p><strong>Aim: </strong>To compare the outcome of laparoscopic totally extraperitoneal repair versus the open Lichtenstein technique in the treatment of primary bilateral inguinal hernias.</p><p><strong>Materials and methods: </strong>The study design was comprised of a matched and randomized research: a total of 93 patients were enrolled in the study and operated in clinic \"<i>Medikom</i>\" from 2015 to 2022. The patients were prospectively randomized and divided into two groups: Group 1 (n=45) underwent TEP repair, whereas Group 2 (n=48) received Lichtenstein repair.</p><p><strong>Result: </strong>No statistically significant differences were observed between the groups concerning the mean age, sex, body mass index, patient distribution by hernia type, European Hernia Society hernia type, and ASA score (<i>p</i>>0.05).The operating time in Group 1 was on 10.7% more than in Group 2 (<i>p</i><0.05). At 6 hours post-surgery, the pain score in Group 2 was 1.19-fold significantly higher than in Group 1 (<i>p</i><0.05). This significant difference persisted at 24 hours post-surgery, with Group 2 exhibiting a pain score 1.27 times greater than Group 1 (<i>p</i><0.05). The time to resumption of normal activities was 1.5 times longer in Group 2 compared to Group 1, which is a difference that reached statistical significance (<i>p</i><0.05). No statistically significant difference was observed regarding the incidence of early complications between the two groups (<i>p</i>>0.05 (χ2-test)). Following a 24-month follow-up period, a total of 42 (93.3%) patients from Group 1 and 45 (93.75%) patients from Group 2 were evaluated. Importantly, neither recurrence nor other complications were observed in either group.</p><p><strong>Conclusions: </strong>The findings of this trial indicate that laparoscopic total extraperitoneal (TEP) hernia repair offers substantial benefits for patients undergoing bilateral inguinal hernioplasty. The duration until resumption of normal activities was 1.5 times significantly longer for patients in the open hernia repair Group 2 compared to those in the laparoscopic hernia repair Group 1.</p>","PeriodicalId":34365,"journal":{"name":"Acta Medica Lituanica","volume":"32 2","pages":"369-376"},"PeriodicalIF":0.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12875561/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146143681","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pott's Puffy Tumour - Rare and Forgotten, yet Relevant and Life-Threatening: Case Report.","authors":"Himraj Phukan, Donboklang Lynser, Gareth Yobel Lyngwa, Chhunthang Daniala, Himesh Barman, Tamajyoti Ghosh","doi":"10.15388/Amed.2025.32.1.6","DOIUrl":"10.15388/Amed.2025.32.1.6","url":null,"abstract":"<p><p>Pott's Puffy Tumour (PPT) is an inflammation and swelling of the forehead secondary to osteomyelitis of the frontal bone. Multiple aetiologies are associated with this condition, predominately involving a prior sinus surgery or a direct trauma to the frontal bone. There can be intracranial extension with an epidural, subdural as well as intracerebral abscess. We present the case of an 8-year-old boy who presented with swelling in his forehead secondary to trauma. His general condition was poor, and further evaluation revealed multiple subdural empyemas. Although PPT is rare in this modern era of antibiotics, it should be kept as a differential for any inflammation of the forehead. Timely diagnosis and the appropriate treatment by a multidisciplinary team are indispensable in reducing the morbidity and mortality associated with this case.</p>","PeriodicalId":34365,"journal":{"name":"Acta Medica Lituanica","volume":"32 1","pages":"206-209"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12239184/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144609833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Calculation of Integral Indicators of the Metabolic Status and Filtration Function of Kidneys in Patients with a Combat Mine-Explosive Injury who Lost Significant Body Weight due to Limb Amputation.","authors":"Nataliia Sydorova, Kateryna Kazmirchuk, Oleh Kolisnyk, Vira Tsaralunha, Yuliia Kobirnichenko, Liudmyla Sydorova","doi":"10.15388/Amed.2025.32.1.2","DOIUrl":"10.15388/Amed.2025.32.1.2","url":null,"abstract":"<p><strong>Background: </strong>The aim of this retrospective cohort study was to investigate the possibility of optimizing the calculation of integral indicators of the metabolic status and filtration function of the kidneys in patients with combat mine-explosive injuries who have lost significant body weight due to limb amputation.</p><p><strong>Methods: </strong>Data from 81 servicemen (all males) with combat mine-explosive limb injuries, including those with isolated severe limb injuries (Group 1, n=34) or traumatic amputations (Group 2, n=47), were analyzed. We assessed demographic indicators and the glomerular filtration rate (GFR), calculated according to the generally accepted formulas with correction for lost body parts in the amputees.</p><p><strong>Results: </strong>The proportion of amputees with obesity as measured by the body mass index in Group 2 without correction for the lost body parts was significantly lower than that in Group 1 and Group 2 adjusted for the lost body parts (2.12% versus 17.65% and 21.28%, respectively, p<0.05 and p<0.01), but it was similar in Group 1 and Group 2 after body weight adjustment for the lost body parts of the amputees (p>0.05). The mean level of serum creatinine in the patients in Group 2 was significantly lower than that in Group 1 (75.19±11.62 vs. 90.93±37.12 μmol/L, respectively, p=0.0206). The estimated GFR according to the <i>Cockcroft and Gault formula</i> (CGF) with adjusted for the lost body part body weight was significantly greater in Group 2 than that in Group 1 (143.63±42.58 and 123.92±26.34 mL/min/1.73m², respectively, p=0.0379) as well as GRF according to CGF corrected for the <i>body surface area</i> (BSA) (131.59±39.94 and 106.17±21.88 mL/min/1.73m², respectively, p=0.0040). Only a few individuals had a moderate decrease in GFR according to CGF or CGF adjusted for BSA, but glomerular hyperfiltration was suspected in a significant number of patients, specifically, 23.53% and 17.65% of the patients in Group 1, respectively, and in 29.79% and 36.17% of the patients in Group 2, respectively (even 51.6% according to CGF corrected for BSA in Group 2 adjusted for the lost body parts).</p><p><strong>Conclusions: </strong>In amputees, it is necessary to calculate their body weight considering the lost body part for an adequate assessment of their metabolic status. To calculate GFR, it is advisable to use CGF considering the lost body parts with or without adjustment for BSA to avoid the possibility of underestimating GFR calculated by other formulas. Special control is necessary for patients with hyperfiltration suspected by CGF, since this sign can be a predictor of future metabolic disorders.</p>","PeriodicalId":34365,"journal":{"name":"Acta Medica Lituanica","volume":"32 1","pages":"64-77"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12239180/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144609807","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Galectin-10 Characterization in Cleft Lip Palate - Affected Palatal Tissue.","authors":"Alise Elizabete Rone, Mara Pilmane","doi":"10.15388/Amed.2025.32.1.3","DOIUrl":"10.15388/Amed.2025.32.1.3","url":null,"abstract":"<p><strong>Background: </strong>Cleft lip palate is one of the most common craniofacial birth defects in humans. Multiple defense factors have been described to have possible involvement in the failure in palatal shelve elevation, migration and fusion, most importantly, the role of chronic inflammation. A widespread presence of Gal-10 in different local inflammatory processes has been discussed before, however, knowledge of its involvement in local tissue inflammation in the postnatal cleft palate and tissue regeneration is scant. This study focuses on the detection of appearance and a possible role of Gal-10 in the cleft-affected facial tissue regarding its ontogenetical aspect.</p><p><strong>Materials and methods: </strong>Craniofacial cleft tissue material was obtained from 21 children aged 8 months to 12.7 years undergoing veloplastic or uranoplastic procedure with non-syndromic craniofacial cleft diagnosis in milk or mixed dentition. Control groups for milk dentition were 5 subjects without orofacial defects for milk dentition and 3 subjects with plastic of superior lip frenula for mixed dentition. The number of factor positive cells in the control group and the patient group tissue was evaluated by using the semiquantitative counting method. The data were evaluated with the use of nonparametric statistical methods.</p><p><strong>Results: </strong>Elevated levels of Gal-10 were found in the epithelium in correlation with age, from milk to mixed dentition, as well as in both the control and the patient samples. Notable differences in expression can be seen by comparing the milk and the mixed dentition patient muscle tissue, where the milk dentition palate shows a more elevated factor expressed in comparison to the mixed dentition palate.</p><p><strong>Conclusions: </strong>The nearly total absence of Gal-10 in the healthy palate with an increase of its expression in the palatal epithelium from the milk to mixed dentition age of cleft-affected children suggests the possible role of this factor in providing the local defense function and the epithelium barrier function. The palatal muscles are not the main place for Gal-10 expression either in healthy or in cleft condition-affected individuals. The sporadic and insignificant appearance of Gal-10 only in the healthy milk dentition age and the mixed dentition age cleft-affected palatal connective tissue prove individual changes in the palatal tissue which does not depend on the specific disease.</p>","PeriodicalId":34365,"journal":{"name":"Acta Medica Lituanica","volume":"32 1","pages":"78-91"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12239170/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144609815","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Potential Role of Placenta Morphological, Cytogenetic and Histological Findings in Fetal Phenotype Modeling: A Case Report with Unanswered Questions.","authors":"Estere Strautmane, Liene Korņejeva, Dzintra Ločmele, Marta Piksena, Diāna Bokučava, Natālija Vedmedovska","doi":"10.15388/Amed.2025.32.1.8","DOIUrl":"10.15388/Amed.2025.32.1.8","url":null,"abstract":"<p><p>Placental abnormalities significantly contribute to fetal mortality. Maternal vascular underperfusion emerges as the prevailing diagnosis. At the same time, genomic alterations within the placenta might play a role in the development of placental dysfunction. We present a case report of a 24-year-old primigravida with an uneventful medical history, admitted at 21 weeks and 2 days gestation. Despite a low risk for typical trisomies, a high risk for preeclampsia and fetal growth restriction (FGR) was recognized in the first trimester. Anhydramnios, abnormal placental morphology, retrochorial and retromembranous hematomas were observed, prompting the termination of pregnancy (TOP). Histological examination revealed multiple placental abnormalities, while the fetus displayed normal anatomy and phenotype. Discussion encompasses the varied manifestations of histopathological findings, and potential associations with adverse pregnancy outcomes. Our case underscores the importance of meticulous evaluation and multidisciplinary collaboration in managing pregnancies with placental anomalies. Further research is crucial to discern the intricate relationship between placental cytogenetics, morphology, and pregnancy outcomes, thus facilitating better clinical management and counseling strategies.</p>","PeriodicalId":34365,"journal":{"name":"Acta Medica Lituanica","volume":"32 1","pages":"240-248"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12239179/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144609838","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neuropsychiatric Manifestations of Lyme Disease: A Literature Review of Psychiatric and Cognitive Impacts.","authors":"Gabija Šegždaitė, Odeta Aliukonytė, Kamilė Pociūtė","doi":"10.15388/Amed.2025.32.1.17","DOIUrl":"10.15388/Amed.2025.32.1.17","url":null,"abstract":"<p><strong>Background: </strong>Lyme disease can lead to neuropsychiatric symptoms like depression, anxiety, and cognitive issues, often mimicking primary psychiatric disorders. This paper examines the connection between Lyme disease and neuropsychiatric outcomes to improve diagnosis and treatment.</p><p><strong>Materials and methods: </strong>The <i>PubMed</i> database was searched for scientific literature sources. Publications published in English in 2019-2024 were selected. All psychiatric symptoms and disorders found to be associated with Lyme disease were included. For neurological symptoms, the analysis focused on studies addressing cognitive dysfunction.</p><p><strong>Results: </strong>Acute neuroborreliosis may have minimal effects on the cognitive function and typically resolves well with treatment. However, some studies suggest that Lyme disease can affect the patients' cognitive abilities, leading to impairments in verbal fluency, attention, and memory, with a few isolated dementia-like cases highlighting the need for careful diagnosis. Nevertheless, recent large-scale studies show no increased risk of dementia. Regarding psychiatric symptoms, findings are also inconsistent, with some studies suggesting an increased risk of depression, anxiety, sleep disturbances, and other mental health conditions, while others find no such association.</p><p><strong>Conclusions: </strong>There is no strong evidence supporting Lyme disease's role in long-term cognitive or psychiatric disorders. However, an early diagnosis and timely antibiotic treatment remain crucial in minimizing long-term consequences and improving patient outcomes.</p>","PeriodicalId":34365,"journal":{"name":"Acta Medica Lituanica","volume":"32 1","pages":"6-21"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12239190/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144609831","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"MRI-Based Diagnosis of Neurocysticercosis with Coexisting Cervical and Lumbar Disc Pathology: A Case Report.","authors":"Sandeep Yadav, Vrinda, Pankaj Kumar, Santosh Kumar Yadav, Dheeraj Kumar","doi":"10.15388/Amed.2025.32.2.20","DOIUrl":"10.15388/Amed.2025.32.2.20","url":null,"abstract":"<p><p>Neurocysticercosis (NCC), a parasitic infection of the central nervous system caused by <i>Taenia solium</i> larvae, is a leading cause of acquired epilepsy in endemic regions. This case describes a 40-year-old male who presented with chronic headache, dizziness, and a recent seizure episode. He had no prior history of systemic illness, tuberculosis, or neurological disorders. Magnetic Resonance Imaging (MRI) of the brain revealed multiple ring-enhancing lesions with an eccentric scolex in the cerebral and cerebellar hemispheres, accompanied by surrounding edema, confirming the diagnosis of neurocysticercosis. Additional lesions in extraocular, facial, and tongue muscles were consistent with myocysticercosis, an uncommon but clinically significant manifestation that may mimic inflammatory or neoplastic processes. Spinal imaging demonstrated degenerative changes, including diffuse cervical disc bulges at multiple levels (C3-C7) and lumbar disc pathology at L4-L5, causing anterior thecal sac indentation but without cord compression or myelomalacia. While the spinal findings were incidental, they were clinically relevant as contributors to chronic pain and potential neurological deficits. The coexistence of disseminated neurocysticercosis with muscular involvement and early degenerative spinal disease highlights the importance of comprehensive evaluation in patients presenting with seizures and persistent headache. Treatment included albendazole-based antiparasitic therapy, corticosteroids to reduce perilesional edema, antiepileptic medications, and conservative management for disc disease. This case underscores the role of MRI in identifying pathognomonic features of cysticercosis, emphasizes the need for systemic evaluation, and demonstrates the significance of recognizing coexisting pathologies for tailored multidisciplinary management.</p>","PeriodicalId":34365,"journal":{"name":"Acta Medica Lituanica","volume":"32 2","pages":"459-466"},"PeriodicalIF":0.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12875550/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146143894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}