Abstracts

Rationale: Seizures are one of the most common symptoms suffered by patients infected with neurocysticercosis (NCC). We sought to characterize the various risk factors associated with developing epilepsy, both well-controlled and medication-resistant, in patients with NCC emigrating from endemic countries to Houston, Texas. Methods: We performed a retrospective chart review of 131 patients with definite or probable NCC based on current diagnostic criteria who have been receiving care at Ben Taub General Hospital, the largest municipal medical facility in Houston, Texas. All patients received imaging studies with either CT or MRI. Patients were divided into two groups, those without seizures or isolated seizures (Group A) and those with epilepsy, both well-controlled and medication-resistant (Group B). Medication-resistant epilepsy was defined as experiencing at least one seizure over the course of 2 months while receiving appropriate antiepileptic drug (AED) treatment. Results: Forty-five patients (34.4%) had epilepsy and 86 patients had either no seizures or an isolated seizure. Twenty-two percent of patients (n=10) in Group B were medication-resistant, with a mean seizure frequency of 1.7 (median: 1) episodes/month. On multivariate analysis, longer duration of disease (12.7 versus 7.5 years, p=0.01), presence of parenchymal disease and calcifications (when compared with extraparenchymal disease) (p=0.02 and 0.05, respectively), and persistence of lesions on follow-up imaging (p=0.02) were significantly associated with epilepsy. Gender, type of seizures, location of lesions, electroencephalographic results, and use of antihelminthics were not associated with developing epilepsy. Conclusions: Our findings suggest that developing epilepsy in NCC is associated with longer duration of symptoms, parenchymal disease, calcifications, and persistent lesions on follow up imaging. Although recurrence rates are low, nearly a quarter of those with recurrent seizures were pharmacoresistant.