title: Natural History of Patients With Perilesional Edema Around Taenia solium Calcified Granulomas.
abstract: BACKGROUND
  The transient development of perilesional edema (PE) around ≥1 calcification (defined as 1 episode) occurs in about 50% of the patients with recurrent seizures in calcified neurocysticercosis (NCC). We determined the long-term clinical and radiological course of persons undergoing PE episodes.
  
  
  METHODS
  Twenty-one persons with NCC who experienced ≥1 PE episode were followed for a median of 10.6 years (range, 0.4-29.2 years). Clinical evaluations and magnetic resonance imaging (MRI) were performed at the time of suggestive symptoms and during routine follow-up.
  
  
  RESULTS
  PE episodes were documented 78 times, involving 50 of 729 calcifications. Episodes reoccurred in all but 3 persons. The pattern, rate, and number of episodes were variable, commonly chronic, and not significantly associated with time from treatment, number of calcifications, or sex. Seizure was the most common symptom, but almost 30% of episodes were asymptomatic and detected by MRI during routine follow-up. Persons with delayed recurrent episodes were significantly older (age, 42.3 vs 28.8 years; P = .045). Seizures continued to occur in 37.5%, and 2 persons had a severe disabling clinical course.
  
  
  CONCLUSIONS
  The number and timing of PE episodes in individuals with calcified NCC are variable and commonly chronic, sometimes recurring over decades. A minority of patients developed significant disability.
authors.affiliation: Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland.
authors.forename: Theodore E
authors.initials: TE
authors.lastname: Nash
authors.affiliation: Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland.
authors.forename: JeanAnne M
authors.initials: JM
authors.lastname: Ware
authors.affiliation: Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland.
authors.forename: Siddhartha
authors.initials: S
authors.lastname: Mahanty
mesh_terms: D000328:Adult; D000368:Aged; D000818:Animals; D001921:Brain / Q000000981:diagnostic imaging; D002114:Calcinosis / Q000000981:diagnostic imaging*; D004487:Edema / Q000453:epidemiology*; D005260:Female; D006099:Granuloma / Q000000981:diagnostic imaging*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D020019:Neurocysticercosis / Q000150:complications / Q000000981:diagnostic imaging*; D012008:Recurrence; D012640:Seizures / Q000453:epidemiology*; D041201:Taenia solium; D055815:Young Adult
keywords: Taenia solium; brain calcifications; brain inflammation; epilepsy; neurocysticercosis