Drug Therapy for Solitary Cysticercus Granuloma: a Systematic Review and Meta-Analysis

Appendix e-2: Eligibility criteria

RCTs were included if the following criteria were met:

1. Study design: Either (a) original RCT comparing the effects of anthelminthic drugs

(including either albendazole or praziquantel) (with or without corticosteroids), versus

no treatment or placebo; or (b) original RCT comparing the effect of corticosteroids

alone (in absence of specific anthelminthic treatment) versus no treatment or placebo.

The use of antiepileptic drugs (AEDs) to prevent seizures was allowable in both

treatment and control groups in both meta-analyses.

2. Selection of subjects: The RCT included subjects who were selected based on the

criteria for solitary cysticercus granuloma as previously described. 1,2 Briefly, the

criteria required clinical and computed tomographic (CT) or magnetic resonance (MR)

evidence for a solitary cysticercus granuloma. Clinical presentation comprised of focal

(with or without secondary generalization) or generalized seizures in the absence of

features of persistent neurological deficits or raised intracranial tension. CT evidence

comprised of a single, small (<20 mm) fluid containing lesion with ring or nodular

type enhancement after contrast administration with mild surrounding edema and no

midline shift. MR evidence was of a single, small (<20 mm) fluid-filled cystic lesion

with or without an eccentric scolex (on T1-weighted images) with surrounding edema

but no midline shift.

3. Description of outcome measures: The RCT clearly described (a) the number of

people with seizure recurrence in both arms following the use of the intervention over

a stated period of follow-up, usually 6-12 months, (b) the incidence of complete

resolution of the granuloma on follow-up imaging and, (c) as an additional secondary

outcome measure, the incidence of residual calcification on follow-up scans. WMO and GS, independently judged the quality of RCTs based on randomization technique (or other method of treatment assignment), allocation sequence, blinding, control of selection bias (intention to treat versus per protocol analysis) and method of outcome assessment prior to their inclusion in the meta-analyses. 3 Disagreements on study inclusion were resolved by consensus.

References

1. Rajshekhar V. Etiology and management of single small CT lesions in patients with seizures: understanding a controversy. Acta Neurol Scand 1991;84:465-470.

2. Singh G, Rajshekhar V, Murthy JM, et al. A diagnostic and therapeutic scheme for a solitary cysticercus granuloma. Neurology 2011;75:2236-2245.

3. Juni P, Altman DG, Egger M. Systematic reviews in health care: Assessing the quality of controlled clinical trials. Bmj 2001;323:42-46.