Neurocysticercosis is a major cause of acquired epilepsy in most developing countries, accounting for their higher prevalence rates of epilepsy. Intraparenchymal brain cysts may resolve by natural evolution or following antiparasitic therapy with either praziquantel or albendazole, leaving in most cases a calcified scar. Many, if not most, patients with NCC will present with symptoms years after the viable infection resolved, but show only calcified lesions on brain CT. However, the long-term consequences of the residual calcified scars have not yet been evaluated despite recent evidence linking neurological symptoms (specifically seizures) to perilesional edema around calcifications. This study will test the hypothesis that new symptoms in patients with calcified cysticercosis, especifically seizures, are associated with the presence of edema around at least one calcified lesion. A prospective, nested case-control study will be performed designed to evaluate the relation of perilesional edema around calcified brain cysticerci and the recurrence of neurological symptoms (specifically seizures). Over 60 patients have already been recruited and 36 more were identified from a cohort of 120 patients with parenchymal, neurocysticercosis who participated in an FDA-funded double blind, randomized study to determine the benefit of albendazole treatment versus placebo. Patients with newly diagnosed calcified neurocysticercosis will be also added into the study cohort to increase sample size. Cases are defined as cohort patients who present a seizure event after at least three months without symptoms. Controls are cohort patients who have had no neurological symptoms in the last three months. Twelve strata defined on age and number of lesions are defined. At the time of appearance of new seizures, the affected individual will be evaluated by MRI together with an asymptomatic control from the same stratum. This design excludes the effects of age and numbers of lesions. The proportion of patients with perilesional edema will be compared between cases and controls to determine the existence and strength of the association.
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