Abstracts

Rationale: The majority of patients with neurocystircercosis (NCC)-related epilepsy are responsive to antiepileptic treatment, however refractory cases do occur. Although cases of NCC with refractory epilepsy have been reported sporadically in the medical literature, surgical treatment has rarely been reported. We present our experience in two patients with medically refractory NCC-related epilepsy who underwent surgery. Methods: The database of the Western Epilepsy program was interrogated and 2 cases were identified. Both cases underwent complete presurgical evaluation after it was established that more than 2 antiepileptic drugs were not successful controlling their seizures. Results: The first case was a 25 year-old man who had right MTS as well as 3 extratemporal calcified cysticerci. He was a Canadian Mennonite with frequent travels to Mexico. Initial presurgical evaluation indicated possible frontal epilepsy, but subsequent placement of intracranial electrodes identified that seizures arose from the right mesial temporal lobe. He underwent a right temporal lobectomy and has been seizure free for over 2 years. The second case was a 30 year-old female, originally from Colombia, who had a cystic lesion (NCC) in the left hippocampus. A lesionectomy and left anterior temporal lobectomy significantly improved her seizures, as she only has occasional auras. Conclusions: Both cases are examples that in some situations NCC-related epilepsy can be refractory to antiepileptic treatment, hence surgical treatment should be considered. In the first case, it was unclear if NCC had a causative role in the development of MTS.