• Theodore E Nash, JeanAnne M Ware, and Siddhartha Mahanty.
• Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland.
• J. Infect. Dis. 2017 Apr 1; 215 (7): 1141-1147.

BackgroundThe 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.MethodsTwenty-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.ResultsPE 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.ConclusionsThe 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.Published by Oxford University Press for the Infectious Diseases Society of America 2017. This work is written by (a) US Government employee(s) and is in the public domain in the US.

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