Calcified parenchymal central nervous system cysticercosis and clinical outcomes in epilepsy

- We compared clinical outcomes in patients with cysticercosis with those in patients with other brain lesions.
- Patients with cysticercosis were equally likely to have refractory epilepsy.
- Depression, but not other psychiatric symptoms, was more common in cysticercosis.
- Parenchymal cysticercosis is a relatively benign disease, but depression may occur.

ObjectiveThis study aimed to compare clinical outcomes including seizure frequency and psychiatric symptoms between patients with epilepsy with neuroimaging evidence of past brain parenchymal neurocysticercosis infection, patients with other structural brain lesions, and patients without structural neuroimaging abnormalities.Material and methodsThe study included retrospective cross-sectional analysis of all patients treated for epilepsy in a community-based adult neurology clinic during a three-month period.ResultsA total of 160 patients were included in the analysis, including 63 with neuroimaging findings consistent with past parenchymal neurocysticercosis infection, 55 with structurally normal brain neuroimaging studies, and 42 with other structural brain lesions. No significant differences were detected between groups for either seizure freedom (46.03%, 50.91%, and 47.62%, respectively; p = 0.944) or mean seizure frequency per month (mean = 2.50, S.D. = 8.1; mean = 4.83, S.D. = 17.64; mean = 8.55, S.D. = 27.31, respectively; p = 0.267). Self-reported depressive symptoms were more prevalent in those with parenchymal neurocysticercosis than in the other groups (p = 0.003). No significant differences were detected for prevalence of self-reported anxiety or psychotic symptoms.ConclusionsCalcified parenchymal neurocysticercosis results in refractory epilepsy about as often as other structural brain lesions. Depressive symptoms may be more common among those with epilepsy and calcified parenchymal neurocysticercosis; consequently, screening for depression may be indicated in this population.