Risk of seizure recurrence in patients of new-onset partial seizure having a solitary cysticercus granuloma of brain or normal neuroimaging

Abstract

Background Solitary cysticercus granuloma – a benign form of parenchymal neurocysticercosis – is considered as the most common cause of partial seizures. This study comparatively evaluated the seizure-related prognosis in patients with new-onset seizure having solitary cysticercus granuloma and in patients with normal neuroimaging. We also assessed the factors of seizure recurrence. Material and method Seventy-four patients of new-onset partial seizure with solitary cysticercus granuloma and 45 patients of new-onset partial seizure with normal neuroimaging were followed up for 6 months. A follow-up neuroimaging was carried out after 3 months. Result Thirteen patients (17.6%) in solitary cysticercus granuloma group and 15 patients (33.3%) in normal neuroimaging group had seizure recurrences ( P = 0.049). In solitary cysticercus granuloma group, family history of seizure disorder ( P = 0.004), headache ( P = 0.029), and serial seizures (at onset) ( P = 0.001) were significantly associated with the seizure recurrence. Granuloma remained unresolved in all patients. In patients with normal neuroimaging, abnormal EEG ( P = 0.043), at inclusion, was only a significant factor of the seizure recurrence. Conclusion The patients with solitary cysticercus granuloma had favorable seizure-related prognosis when compared with patients having normal neuroimaging. Serial seizures and headache predicted seizure recurrence in patients with solitary cysticercus granuloma. The presence of electroencephalographic abnormality predicted seizure recurrence in patients with normal neuroimaging.