Edema associated with calcified lesions in neurocysticercosis

Objective: To determine serial MRI and CT abnormalities around calcified cy sts due to cysticercosis in previously treated patients during periods of s eizure activity. Background: Some patients with calcified lesions due to cy sticercosis have seizures. How and why seizures occur in this setting are u nknown, Methods: Three patients with known, treated cysticercosis were stud ied prospectively by serial MRI and CT before, during, and after seizure ac tivity. Results: All three patients demonstrated edema surrounding calcifie d lesions. Two of three patients had repeated episodes involving the same c alcified lesions, and their symptoms corresponded to the location of the le sion. Enhancement was present in the lesions demonstrating edema, but was a lso present surrounding other nonsymptomatic calcified lesions. Conclusions : Perilesional edema surrounding calcified lesions due to cysticercosis occ urs in some patients at the time of seizure activity. Repeated seizure epis odes tend to be associated with the same lesions. Although the mechanisms i nvolved are unknown, long-term antiseizure medication is likely indicated i n these patients. Current evidence does not support the use of specific ant iparasitic treatment in these patients.