Medical Treatment for Neurocysticercosis: Drugs, Indications and Perspectives

Fleury, Agnès; Jung, Hyejin; Cárdenas, Graciela; Sciutto, Edda

doi:10.2174/156802608783790811

Cited by 27 publications

(6 citation statements)

References 84 publications

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“…It is also possible that the lesser penetration of ABZ in the subarachnoidal space could participate in the SA-NC resistance. Another factor involved in this phenomenon could be related to the variability in plasma and CSF ABZ sulphoxide levels among patients due to individual differences in bioavailability [2]. The high levels of corticosteroids used to prevent complications due to severe CSF inflammation may also turn-off key immunological components crucial for the parasite destruction.…”

Section: Resultsmentioning

confidence: 99%

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Subarachnoidal Neurocysticercosis non-responsive to cysticidal drugs: a case series

et al. 2010

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BackgroundNeurocysticercosis (NC) is one of the most frequent parasitic diseases of the central nervous system. Cysticidal drugs, albendazole and praziquantel, are generally effective when parasites localize in the parenchyma. In contrast, parasites lodged in the subarachnoid basal cisterns are less responsive to treatment.Case PresentationThe clinical and radiological pictures of six Mexican patients non-respondent to cysticidal treatment are presented.ConclusionsThe possible factors involved in the cysticidal non-response are discussed and hints are provided of potentially useful changes to therapeutic protocols.

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Section: Resultsmentioning

confidence: 99%

“…The introduction of cysticidal drugs, albendazole (ABZ) and praziquantel (PZQ), for the treatment of NC have dramatically improved its prognosis [2]. In Mexico, ABZ is becoming the drug of choice due to its low costs and availability.…”

Section: Introductionmentioning

confidence: 99%

Subarachnoidal Neurocysticercosis non-responsive to cysticidal drugs: a case series

et al. 2010

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“…In contrast, extraparenchymal NCC may cause permanent sequelae, such as cognitive problems and hydrocephalus, with a risk of death 10, 25. Higher doses of cysticidal drugs and longer anti‐inflammatory treatment are frequently required 34, 35, 36. In this context, the high specificity of these new criteria is of great relevance, demonstrating that the risk of false‐positive diagnosis is low.…”

Section: Discussionmentioning

confidence: 99%

New diagnostic criteria for neurocysticercosis: Reliability and validity

Carpio

Fleury

Romo

et al. 2016

Annals of Neurology

110

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ObjectiveThe diagnosis of neurocysticercosis (NCC) remains problematic because of the heterogeneity of its clinical, immunological, and imaging characteristics. Our aim was to develop and assess a new set of diagnostic criteria for NCC, which might allow for the accurate detection of, and differentiation between, parenchymal and extraparenchymal disease.MethodsA group of Latin American NCC experts developed by consensus a new set of diagnostic criteria for NCC. A multicenter, retrospective study was then conducted to validate it. The reference standard for diagnosis of active NCC was the disappearance or reduction of cysts after anthelmintic treatment. In total, three pairs of independent neurologists blinded to the diagnosis evaluated 93 cases (with NCC) and 93 controls (without NCC) using the new diagnostic criteria. Mixed‐effects logistic regression models were used to estimate sensitivity and specificity.ResultsInter‐rater reliability (kappa) of diagnosis among evaluators was 0.60. For diagnosis of NCC versus no NCC, the new criteria had a sensitivity of 93.2% and specificity of 81.4%. For parenchymal NCC, the new criteria had a sensitivity of 89.8% and specificity of 80.7% and for extraparenchymal NCC, the new criteria had a sensitivity of 65.9% and specificity of 94.9%.InterpretationThese criteria have acceptable reliability and validity and could be a new tool for clinicians and researchers. An advantage of the new criteria is that they consider parasite location (ie, parenchymal or extraparenchymal), which is an important factor determining the clinical, immunological, and radiological presentation of the disease, and importantly, its treatment and prognosis. Ann Neurol 2016;80:434–442

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“…In cases with >2 viable cysticerci, combination therapy of albendazole (15 mg/kg/ day PO in two divided doses) with Praziquantel (50 mg/kg/day in 3 divided doses) for 10-14 days is recommended [57,58]. Albendazole impairs glucose uptake by the larvae and adult stages, depletes glycogen stores, and decreases adenosine triphosphate (ATP) production, leading to parasite death [59,60]. Praziquantel causes rapid, sustained muscular contraction and tegumental disruption, exposing the parasite antigens to the immune system [59,60].…”

Section: Antiparasitic Treatmentmentioning

confidence: 99%

“…Albendazole impairs glucose uptake by the larvae and adult stages, depletes glycogen stores, and decreases adenosine triphosphate (ATP) production, leading to parasite death [59,60]. Praziquantel causes rapid, sustained muscular contraction and tegumental disruption, exposing the parasite antigens to the immune system [59,60].…”

Section: Antiparasitic Treatmentmentioning

confidence: 99%

Neurocysticercosis and the Central Nervous System: Advancements in Diagnosis, Treatment, and Future Prospects

Aderinto,

Olatunji,

Kokori

et al. 2024

Intestinal Parasites - New Developments in Diagnosis, Treatment, Prevention and Future Directions [Working Title]

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Neurocysticercosis presents a formidable global health challenge. This parasitic infection induces cystic lesions, primarily in the brain and spinal cord, leading to neurological symptoms and complications. Global prevalence varies, driven by socioeconomic conditions, cultural practices, and dietary habits, particularly in low and middle-income countries. Diagnosis remains challenging, relying on clinical, serological, and neuroimaging findings, with advanced tools like CT and MRI scans enhancing accuracy. Treatment strategies involve antiparasitic medications, anti-inflammatory drugs, and surgical interventions. Ongoing research explores innovative diagnostics and treatments, emphasising a comprehensive, individualised approach. A One Health approach, integrating human, animal, and environmental health, is crucial for effective prevention. Exploring the socioeconomic impacts, ethical considerations, and technology integration, including telemedicine, is paramount. Understanding cultural factors influencing healthcare-seeking behaviour contributes to culturally sensitive interventions. Technology integration can improve diagnostic capabilities and healthcare access, especially in regions with limited resources.

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Medical Treatment for Neurocysticercosis: Drugs, Indications and Perspectives

Cited by 27 publications

References 84 publications

Subarachnoidal Neurocysticercosis non-responsive to cysticidal drugs: a case series

Subarachnoidal Neurocysticercosis non-responsive to cysticidal drugs: a case series

New diagnostic criteria for neurocysticercosis: Reliability and validity

Neurocysticercosis and the Central Nervous System: Advancements in Diagnosis, Treatment, and Future Prospects

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