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Posted On : 05 Feb 2016

a 8 yrs girl came with simple partial seizure.her CT report
is as under-ONE RING ENHANCING INFLAMATORY GRANALUMATOUS LESION IN RT PARIETAL REGION WITH
PERIFOCAL VASOGENIC OEDEMA.CONTACT HISTORY FOR TB IS POSITIVE. HOW SHOULD WE DIFFERENTIATE BETWEEN TUBERCULAR AND NEUROCYSTICERCOSIS.Pt CAN NOT AFFORD MRI.

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Answer 1

To differentiate between neurocysticercosis and tuberculoma on CT scan, following are the differences:
1. in tuberculosis, the lesion is usually More than 20 mm, while in NCC it is Less than 20 mm
2. in tuberculosis, the lesion is irregular in outline. In NCC it is regular
3. in tuberculosis, the lesion may produce a midline shift. In case of NCC, it does not usually produce a midline shift.

These criteria are not absolute or 100 percent accurate. They have to be correlated clinically.

Other investigations to support the diagnosis of Tuberculosis can be done like Mantoux test, Xray chest, GL for AFB, CSF study {unless contraindicated due to tuberculoma}. For NCC serological tests can be done like ELISA or EITB.

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