Epilepsy surgery and neurocysticercosis: Assessing the role of the cysticercotic lesion in medically-refractory epilepsy

摘要

Abstract There is increasing evidence of the existence of refractoriness to treatment with antiepileptic medications in those with NCC-related epilepsy. We performed a systematic review with the objective to determine the role of a cysticercotic lesion in this group of patients. We sought those manuscripts, including case reports, describing patients with NCC-related medically-intractable epilepsy who underwent epilepsy surgery and were seizure-free a year after. Only 10 manuscripts fulfilled inclusion and exclusion criteria. Three different clinical presentations were identified: 1) the cysticercotic lesion was epileptogenic, 2) there was dual pathology, including the cysticercotic lesion, with the other lesion usually being hippocampal sclerosis, and 3) the cysticercotic lesion was not related to the epileptogenic focus. In the case of an epileptogenic cysticercotic lesion, the presence of gliosis appeared to be the culprit for epileptogenicity. More studies using large cohorts of patients might be able to confirm our findings. This article is part of a Special issue entitled “Neurocysticercosis and Epilepsy”. Highlights ? Cases of NCC-related medically-intractable epilepsy have been reported in the literature, with more frequency lately. ? Three different clinical presentations have been found in those with NCC-related medically-intractable epilepsy. ? Resection of the epileptogenic focus, which may include a cysticercotic lesion, will render patients seizure-free. ? Gliosis was found to be a common pathological finding in those with epileptogenic cysticercotic lesions.