Cysticidal therapy: impact on seizure control in epilepsy associated with neurocysticercosis

ABSTRACT

OBJECTIVE: To evaluate the clinical features and seizure control of epilepsy related to neurocysticercosis. METHOD: 18 patients with partial epilepsy and neurocysticercosis were treated with albendazol or praziquantel and followed from 3 months to 12 years. We analyzed results from the CSF exam, interictal electroencephalogram (EEG), head computerized tomography and/or magnetic resonance imaging. RESULTS: The patients' mean age was 36.4 years. The mean duration of epilepsy was 16 years. 83 percent patients had simple partial seizures ; 17 percent had complex partial seizures . All patients underwent routine EEGs: 62 percent had abnormalities and 38 percent were normal. A relationship was observed between focal EEG abnormality and the location of cyst in 28 percent of the patients. The CSF exams showed pleocytosis in 33 percent of the patients, and 28 percent had elevated protein levels. Only 22 percent of patients had positive titer for cysticercosis in the CSF. In all patients who had somatosensory and special sensory seizures there was a relationship between location of the cysts and seizure semiology (n=11). After cysticidal therapy, 83 percent patients had a significant improvement in controlling seizures. CONCLUSION: In this group, we found a predominance of simple partial seizures and a relationship between somatosensory and special sensory seizures and the location of the cysts. Cysticidal therapy was effective in controlling seizures in these patients and should be considered for patients with partial seizures and semiology related to cyst location