Abstracts

Rationale: To determine the role of a Neurocysticercotic lesion (NCC) as an epileptogenic lesion and its contribution in drug-resistant epilepsy (DRE).Methods: MEDLINE, EMBASE, Scopus and LILACS were interrogated, since their inception until May of 2013, searching for case reports and case series of patients with NCC and DRE. We investigated all cases where the ictal-onset zone was determined with standard pre-surgical evaluation in an epilepsy center. Only cases in which there was concordance between the anatomical location of NCC and the ictal-onset zone were included. Abstracted data included semiology of seizures, presence of other lesions in imaging, type of pre-surgical investigations, surgical treatment, seizure outcomes and histological reports.Results: A total of 4407 references were identified using terms related to cysticercosis and epilepsy. After the first screening, 57 documents were read and critically reviewed. 5 final articles were selected. They included 13 patients. Nine (69.2%) of the patients had NCC in the temporal lobe. Mesial temporal sclerosis (MTS) was detected using MRI imaging in four (30.8%) patients (three had a NCC in the temporal lobe and one in the parietal lobe). One patient with frontal NCC had recurrent perilesional edema. Four patients (30.8%) required extensive pre-surgical investigation (one with invasive recording and three with PET scan). Eleven patients had epilepsy surgery, and 10 of them became seizure free at least 13 months. Details about histological description were available only in two patients, both demonstrated perilesional gliosis.Conclusions: NCC rarely represents the ictal-onset zone in patients with DRE. There is a need of prospective studies to clarify the association between NCC and MTS, the rol of perilesional gliosis in NCC, and the role of NCC in DRE.