Abstracts

RATIONALE: Neurocysticercosis (NC) is an endemic disease in many developing countries. Half of the patients with NC have epilepsy and in half of them CC can be seen on CT scanning. This paper discusses the localizatory value of the CC in patients with refractory TLE and MRI-defined MTS. METHODS: Twenty-five patients with refractory TLE, MRI-defined MTS and CC were studied. All patients were submitted to a cortico-amygdalo-hippocampectomy at the side of the MTS. Six patients had a single CC and in only 1 of them the CC was found at the same side as the MTS; this occurred in 5 out of 19 patients with multiple CC. Eighteen patients had unilateral interictal temporal lobe discharges while in 7 bilateral discharges were seen. Age ranged from 18 to 48 years (m=30), seizure frequency from 1-10/week (m=3) and the follow-up time from 10-48 months (m=19). RESULTS: Twenty-three patients have been seizure-free since surgery; 2 patients are in Engel's class II (1 with a single and one with multiple CC). There was no surgical morbidity or mortality. CONCLUSIONS: MTS, rather then CC, has a major localization value in the studied population. Patients with CC and otherwise normal MRI still represent a challange in terms of focus localization and should be investigated as if no CC has been detected. Eight percent of the patients from our epilepsy surgery series have MTS and CC, a very high prevalence rate, even when considering the prevalence of NC in the general population. In these patients, MTS may have been generated by repeated focal or diffuse encephalitic events related to the degeneration of NC vesicles.