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Perilesional Brain Edema Associated with Seizures

Perilesional edemas around calcified lesions may lead to an increased risk of episodic seizure activity


THURSDAY, Nov. 6 (HealthDay News) -- Perilesional edema is a common occurrence associated with episodic seizures in patients with calcified neurocysticercosis, an infection with the larval form of Taenia solium, according to a report published online Nov. 4 in The Lancet Neurology.

This prospective cohort study, led by Theodore E. Nash, M.D., of the National Institute of Allergy and Infectious Diseases at the National Institutes of Health in Bethesda, Md., and colleagues followed 110 patients with calcified lesions and a history of seizures or severe headaches. MRI was used to determine the presence of perilesional edema at the time of seizure (within five days) in symptomatic and matched asymptomatic control patients.

During the study period (November 1999 to December 2006), 29 patients experienced an episodic seizure, leading to a five-year incidence of 36 percent, the researchers report. Of these 29 patients, 24 (83 percent) underwent MRI. A perilesional edema was observed upon MRI evaluation in 50 percent of the symptomatic patients, compared with only 9 percent of the asymptomatic matched controls, the investigators found.

"Our findings are probably representative of symptomatic patients in regions where T. solium neurocysticercosis is endemic and suggest a unique and possibly preventable cause of seizures in this population," according to the study authors. An accompanying editorial adds, "this trial offers hope for improvement in the management of people with epilepsy in developing countries."

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