Epilepsia secundaria a neurocisticercosis

Epilepsy is the most frequent clinical manifestation of neurocysticercosis, occurring in 50% to 70% of cases. It is more common in patients with parenchymal brain lesions, and may be related to the presence of the parasite itself or to the inflammatory changes that such parasites induce in the surrounding brain parenchyma. Seizures may be generalized or partial and may be associated with other manifestations of the disease, including headache, dementia or focal neurological signs. Diagnosis is established by CT showing characteristic lesions of this disease, including calcifications, cystic lesions or ring-enhancing lesions. EEG and immunological tests for the detection of anticysticercal antibodies are of no value in the diagnosis of epilepsy due to NCC. Patients with active lesions must be treated with anticysticercal drugs since the use of these drugs allow a better control of seizures. Antiepileptic drugs could be withdrawn in patients who are free of seizures for two years. It must be kept in mind that the risk of seizure recurrence is high in patients whose CT show residual calcifications and in those who had both multiple seizures and multiple parenchymal brain cysts before the start of cysticidal drug therapy.