Brain echinococcal disease in Pondicherry.

A 29-year-old man, a vegetarian, agriculturist and resident of a village near Pondicherry, presented with focal seizures with secondary generalization. EEG showed a right frontoparietal focus, the blood eosinophil count was 25%, the indirect haemagglutination titre was more than 1:2048 for Echinococcus protein and Casoni's skin test was strongly positive, the CT scan showed an isolated rounded lesion in the right frontoparietal area partially enhanced with contrast media. He was subjected to surgery with complete removal of the cyst which confirmed the diagnosis of echinococcal disease of the brain. Post operatively he took only anticonvulsant drugs and was free of seizures during the two-year post-operative follow-up period. The CT scan is a superior neurodiagnostic tool to blood serological tests in the diagnosis of brain echinococcal disease.