Recurrent headaches may be caused by cerebral toxoplasmosis

Table 4 Results of laboratory tests and head X-ray/neuroimaging studies in the seropositive anti-Toxoplasma gondii IgG children with recurrent headaches

Pt	ESR (mm/h)	WBC (103/mL)	CRP (mg/L)	EEG	Head X-ray/CT/MRI
1		6.4		Increased percent of slow waves	CT normal
2	10	14.9	0.10	Abnormal	CT normal
3		4.0; 6.5	20.25; 1.92	Normal	MRI-brain and fluid spaces normal, massive lesions of paranasal sinuses, total obliteration of the right maxillary sinus, thickened ethmoid mucosa
4		5.4	0.57	Paroxysmal parietal and temporal alterations without paroxysmal activity	MRI-arachnoidal cyst at the right frontal-parietal border
5	22	6.9		Normal	CT normal; X-ray-thickened right sphenoid mucosa
6		6.9		Discrete bilateral alterations in frontal regions	MRI-arachnoidal cyst, underdevelopment of Turkish saddle diaphragm; X-ray-thickened right maxillary sinus mucosa
7		6.5	0.27	Discrete bilateral alterations in temporal regions-increased slow waves	MRI-brain and fluid spaces normal, small and hypoplastic frontal sinuses with thickened mucosa, moderate thickening of ethmoid mucosa and moderate inflammatory or post-inflammatory lesions of maxillary sinuses
8	16	5.7	0.30	Generalized alterations	MRI-extensive lesions (differentiation between metabolic and demyelinating disorder)
9		7.1		Generalized alterations: many dispersed theta waves; biparietal paroxysmal alterations during HV	CT and sinus X-ray normal
10	12	8.4	0.60	Normal	CT normal
11		4.7	0.86	Readout unavailable-pending	Head CT and X-ray of cervical spine normal; MRI-modest lateral ventricle asymmetry, some minute fluid foci adjacent to pineal gland
12		7.5		Normal	MRI normal
13a	8	4.5	0.41	Increased percent of slow waves; increased number of theta waves during HV	MRI demyelinating foci (June 2009); partial regression of these abnormalities (February 2010)
14		6.9	0.39	Slowed down basal function, biparietal alterations	MRI normal
15	24	9.2	1.45	Paroxysmal bioccipital alterations	MRI-venous angioma suspected in right cerebellar hemisphere; X-ray-Kimmerle foramen in C1 of cervical spine
16	9	6.59			CT normal
17		10.6		Normal	MRI-discrete lesions in the vicinity of dorsal parts of lateral ventricle corpora, paraventricular foci of demyelination?
18			0.24	Normal	CT-isolated tiny hypodense foci in midbrain and pons
19	N/A	7.9	N/A	Normal	MRI-choroid plexus cysts

¹In Pt 13, the anti-streptolysin titer was 530 U (n≤ 200 U). WBC: White blood cells; CRP: C-reactive protein (n≤ 5 mg/mL); HV: Hyperventilation; N/A: Data not available; CT: Computed tomography; MRI: Magnetic resonance imaging; ESR: Erythrocyte sedimentation rate; EEG: Electroencephalography.