title: Albendazole therapy for single small enhancing CT lesions (SSECTL) in the brain in epilepsy.
abstract: BACKGROUND
  Single small enhancing CT lesions (SSECTL) of the brain with or without perifocal oedema are common in patients with symptomatic epilepsy in India. Solitary cysticercus granuloma, a benign form of parenchymal neurocysticercosis, is considered to be the most common aetiology for SSECTL. Definite information is lacking regarding the effectiveness of antiparasitic treatment on resolution of these lesions and on long term seizure recurrence.
  
  
  OBJECTIVE
  To evaluate the response to albendazole treatment in patients who had SSECTL and new onset seizures treated with antiepileptic drugs (AED) in a prospective clinical trial.
  
  
  METHODS
  43 patients who presented with new onset seizures and were documented to have SSECTL were alternatively allocated to receive albendazole 15 mg/kg/day for 2 weeks or no cysticidal therapy. All patients were treated with AED and followed for at least 6 months for seizure recurrence, and serial CT scans were obtained at 4 weeks, 3 months and at study completion.
  
  
  RESULTS
  28 (65%) patients were aged 5-25 years and 31 (72%) presented clinically with partial motor seizures with or without generalisation. Most of the SSECTL were ring lesions (75%) and located in and around the sensory-motor cortex at the gray-white junction (65%). In the albendazole group, 56% of patients compared with 35% in the control group showed resolution of SSECTL (p = 0.154) at 1 month. 22 of 23 patients (95.6%), who received albendazole, compared with 14 of 20 patients (70%) in the control group, demonstrated radiological resolution on study completion (p = 0.03). Punctate residual calcification and seizure recurrence were observed in four patients (9.3%) in the control group and in three (7%) patients in the albendazole group (p = 0.47).
  
  
  CONCLUSIONS
  In patients presenting with seizures due to single viable parenchymal neurocysticercosis, albendazole hastens the resolution of SSECTL if treatment is given in the early phase of the illness.
authors.affiliation: Neurology Unit, Department of Medicine, Amiri Hospital, Ministry of Health, Kuwait. a_thussu@hotmail.com
authors.forename: A
authors.initials: A
authors.lastname: Thussu
authors.forename: A
authors.initials: A
authors.lastname: Chattopadhyay
authors.forename: I M S
authors.initials: IM
authors.lastname: Sawhney
authors.forename: N
authors.initials: N
authors.lastname: Khandelwal
mesh_terms: D000293:Adolescent; D000328:Adult; D015766:Albendazole / Q000627:therapeutic use*; D000871:Anthelmintics / Q000627:therapeutic use*; D002220:Carbamazepine / Q000627:therapeutic use; D002540:Cerebral Cortex / Q000000981:diagnostic imaging / Q000469:parasitology; D002648:Child; D002675:Child, Preschool; D004827:Epilepsy / Q000469:parasitology / Q000517:prevention & control*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020019:Neurocysticercosis / Q000150:complications / Q000000981:diagnostic imaging* / Q000188:drug therapy*; D010672:Phenytoin / Q000627:therapeutic use; D011446:Prospective Studies; D012008:Recurrence; D012640:Seizures / Q000469:parasitology / Q000517:prevention & control; D014057:Tomography, X-Ray Computed
chemical_list: D000871:Anthelmintics; D002220:Carbamazepine; D010672:Phenytoin; D015766:Albendazole