title: Seizure recurrence in patients with solitary cystic granuloma or single parenchymal cerebral calcification: a comparative evaluation.
abstract: BACKGROUND
  Solitary cysticercus granuloma and single parenchymal calcified lesion are two common neuroimaging abnormalities in Indian patients with epilepsy. In this study, we evaluated the frequency and predictors of seizure recurrence in patients presenting with new onset epilepsy or single epileptic seizures and these two different imaging findings.
  
  
  METHODS
  We enrolled 115 patients with newly diagnosed epilepsy. All patients were clinically evaluated and were treated with oxcarbazepine. No anti-helminthic treatment was prescribed. The patients were followed up for 6 months. In the solitary cystic granuloma group, repeat computed tomography was done after 6 months.
  
  
  RESULTS
  The study included 80 patients with solitary cysticercus granuloma and 35 patients with a single calcified lesion. Twenty (25%) patients with solitary cysticercus granuloma and 12 (34.3%) patients with parenchymal calcified lesion had a seizure recurrence during the study period (p = 0.307). After 6 months, 57 (71.3%) patients in the solitary cysticercus granuloma group demonstrated complete resolution of the granuloma and in 21 (26.2%) patients the granuloma transformed into a calcified lesion. In the solitary cysticercus granuloma group, a family history of seizure, serial seizures and calcification on follow-up neuroimaging (p < 0.05) were significantly associated with recurrence of seizures. In patients with a single parenchymal calcified lesions, electroencephalographic abnormalities and serial seizures (p = < 0.05) were significant predictors of recurrence. Kaplan-Meier statistics revealed that the seizure recurrence rate was insignificantly higher in patients with calcified lesions than in patients with solitary cysticercosis granulomas.
  
  
  CONCLUSIONS
  In conclusion, in patients with solitary cysticercus granuloma, a family history of seizures, serial seizures and calcification of the granuloma, and in patients with a calcified brain lesion, electroencephalographic abnormalities, family history of epilepsy and serial seizures were associated with an increased risk of seizure recurrence.
authors.affiliation: Department of Neurology, King George Medical University, Lucknow, Uttar Pradesh, India.
authors.forename: Laxmi Narayan
authors.initials: LN
authors.lastname: Sharma
authors.forename: Ravindra Kumar
authors.initials: RK
authors.lastname: Garg
authors.forename: Rajesh
authors.initials: R
authors.lastname: Verma
authors.forename: Maneesh Kumar
authors.initials: MK
authors.lastname: Singh
authors.forename: Hardeep Singh
authors.initials: HS
authors.lastname: Malhotra
mesh_terms: D000293:Adolescent; D000328:Adult; D001921:Brain / Q000000981:diagnostic imaging; D001927:Brain Diseases / Q000150:complications* / Q000000981:diagnostic imaging; D002114:Calcinosis / Q000150:complications* / Q000000981:diagnostic imaging; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006099:Granuloma / Q000150:complications* / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D020019:Neurocysticercosis / Q000150:complications* / Q000000981:diagnostic imaging; D011446:Prospective Studies; D011859:Radiography; D012008:Recurrence; D012640:Seizures / Q000000981:diagnostic imaging / Q000209:etiology*
keywords: Computed tomography; Cysticercosis; Epilepsy; Neurocysticercosis