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Albendazole therapy for single small enhancing CT lesions (SSECTL) in the brain in epilepsy

¹ Neurology Unit, Medical Department, Amiri Hospital, Kuwait
² Department of Internal Medicine, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
³ Morriston Hospital, Swansea NHS Trust, Wales, UK
⁴ Department of Radiology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India

Correspondence to:
Dr A Thussu, Neurology Unit, Department of Medicine, Amiri Hospital, Ministry of Health, Kuwait; a_thussu{at}hotmail.com

Objective: To evaluate the response to albendazole treatment in patients who had SSECTL and new onset seizures treated with antiepileptic drugs (AED) in a prospective clinical trial.

Methods: 43 patients who presented with new onset seizures and were documented to have SSECTL were alternatively allocated to receive albendazole 15 mg/kg/day for 2 weeks or no cysticidal therapy. All patients were treated with AED and followed for at least 6 months for seizure recurrence, and serial CT scans were obtained at 4 weeks, 3 months and at study completion.

Results: 28 (65%) patients were aged 5–25 years and 31 (72%) presented clinically with partial motor seizures with or without generalisation. Most of the SSECTL were ring lesions (75%) and located in and around the sensory–motor cortex at the gray–white junction (65%). In the albendazole group, 56% of patients compared with 35% in the control group showed resolution of SSECTL (p = 0.154) at 1 month. 22 of 23 patients (95.6%), who received albendazole, compared with 14 of 20 patients (70%) in the control group, demonstrated radiological resolution on study completion (p = 0.03). Punctate residual calcification and seizure recurrence were observed in four patients (9.3%) in the control group and in three (7%) patients in the albendazole group (p = 0.47).

Conclusions: In patients presenting with seizures due to single viable parenchymal neurocysticercosis, albendazole hastens the resolution of SSECTL if treatment is given in the early phase of the illness.

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