Epilepsy due to neurocysticercosis is heterogeneous: acute symptomatic seizures occur due to cyst degeneration and consequent inflammation, while unprovoked seizures often result from scarring around a dying parasite or a healed granuloma. This work describes a randomised controlled trial of albendazole in solitary cerebral cysticercosis, with serial MR imaging using magnetisation transfer to explore the natural history of the disease and the development of perilesional gliosis. The findings of this study have interesting implications for seizure recurrence in patients with chronic epilepsy due to neurocysticercosis, and will help guide anti-epileptic drug treatment in such patients.