Prognosis of epilepsy associated with single CT enhancing lesion: a long term follow up study

This is a retrospective analysis to study the long term prognosis of epilepsy associated with single CT enhancing lesion (SCTEL). Follow up CT scan showed resolution of the lesion in all of the 102 patients. Seizures did not recur in 64 (63%) patients after starting antiepileptic drugs. Twenty eight (27.5%) patients had recurrence of seizures for a median period of 2 months before remission was achieved. In the remaining ten (10%) patients seizures remitted only after albendazole therapy and the median period of seizure recurrence was 8 months. Sixteen (42%) of the 38 patients who had recurrence of seizures had type B CT lesion (ring lesion with central enhancing area, probably scolex) (P<0.02 (95% CI 3.2-40.3)). Patients with type B CT lesion had more numbers of seizures and also longer intervals between first and last seizure. Antiepileptic drugs were withdrawn in all the 102 patients. The mean period of follow up was 45 months (range 19-101). Only one patient had a relapse and his follow up CT showed gliotic scar at the site of the previous lesion. We conclude that epilepsy associated with SCTEL is a benign form of epilepsy and seizures recur as long as the lesion persists. Antiepileptic drugs can safely be withdrawn once the follow up CT shows resolution of the lesion.