The Use of Albendazole in Patients with Single Lesions Enhanced on Contrast CT

Oh, Del Brutto

doi:10.1056/nejm199302043280517

Cited by 34 publications

(17 citation statements)

References 4 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Rapid clearance of the parasite may not lead to a decrease in chronic brain irritation, as was earlier expected. Thus, even though cysticides do hasten cyst resolution when administered in the early degenerating stage 34,35 , this may not translate into less perilesional scarring and thus better seizure control. Moreover, as discussed above, histologic abnormalities in the perilesional area may not be seen as MT hyperintensities, and may manifest as lower MTR values only.…”

Section: Effect Of Albendazole Therapy On the Evolution Of Perilesionmentioning

confidence: 99%

Prospective Quantitative Imaging Study by Magnetisation Transfer for Appearance of Perilesional Gliosis in Solitary Cerebral Cysticercal Lesion

et al. 2010

View full text Add to dashboard Cite

This study aimed to detect perilesional gliosis around solitary cerebral cysticerci (SCC) by magnetisation transfer imaging (MTI), to compare its incidence between patients administered and not administered albendazole. We prospectively randomised patients with SCC and new-onset seizures to treatment with albendazole plus antiepileptics (treatment), or antiepileptics only (control), and performed MRI scans at zero, three, six, 12 and 24 months. Data were analysed for lesion characteristics, perilesional MT hyperintensity and MT ratios, calculated from the lesion and perilesional area. Eighty-one patients' data were analysed (M-41, F-40; ages 6-52 years). About 13% scolices appeared hyperintense on MTI at baseline. T1-isointense cyst walls and perilesional area showed MT hyperintensity in 30 - 41.4%; this proportion increased over time. Persistently visible SCC and stage of degeneration at enrolment did not predict development of MT hyperintensity. MT ratios (range - 98.75 to 49.79) increased over time and differed significantly from normal parenchyma. No difference in MT ratios was noted between treatment and control groups. Qualitative perilesional MT hyperintensity was more often seen in control group. Perilesional gliosis is present in >20% of SCC at six months, and continues to appear on later scans. Gliosis is independent of lesion persistence and stage of degeneration. Pre- and post-contrast MT imaging is equally useful in detection of gliosis. MT ratios from the lesion and perilesional parenchyma are significantly lower than from normal brain tissue at all stages of degeneration, but increase as degeneration occurs and healing progresses. Albendazole therapy does not affect the formation of perilesional gliosis.

show abstract

Section: Effect Of Albendazole Therapy On the Evolution Of Perilesionmentioning

confidence: 99%

Prospective Quantitative Imaging Study by Magnetisation Transfer for Appearance of Perilesional Gliosis in Solitary Cerebral Cysticercal Lesion

et al. 2010

View full text Add to dashboard Cite

show abstract

“…Among many case series (19,20,34,36,(85)(86)(87)99), only three randomized, controlled trials of albendazole have been reported on patients with single enhancing lesions. Two studies demonstrated no significant difference in radiographic resolution (79,93).…”

Section: Vol 15 2002 Guidelines For Treatment Of Neurocysticercosismentioning

confidence: 99%

Current Consensus Guidelines for Treatment of Neurocysticercosis

et al. 2002

Self Cite

View full text Add to dashboard Cite

Taenia solium neurocysticercosis is a common cause of epileptic seizures and other neurological morbidity in most developing countries. It is also an increasingly common diagnosis in industrialized countries because of immigration from areas where it is endemic. Its clinical manifestations are highly variable and depend on the number, stage, and size of the lesions and the host's immune response. In part due to this variability, major discrepancies exist in the treatment of neurocysticercosis. A panel of experts in taeniasis/cysticercosis discussed the evidence on treatment of neurocysticercosis for each clinical presentation, and we present the panel's consensus and areas of disagreement. Overall, four general recommendations were made: (i) individualize therapeutic decisions, including whether to use antiparasitic drugs, based on the number, location, and viability of the parasites within the nervous system; (ii) actively manage growing cysticerci either with antiparasitic drugs or surgical excision; (iii) prioritize the management of intracranial hypertension secondary to neurocysticercosis before considering any other form of therapy; and (iv) manage seizures as done for seizures due to other causes of secondary seizures (remote symptomatic seizures) because they are due to an organic focus that has been present for a long time

show abstract

“…Later, other authors duplicated this procedure by using albendazole (149,150). Unfortunately, the latter authors did not perform a randomized, double-blind, placebo-controlled design.…”

Section: Single Inflammatory Lesion and Seizuresmentioning

confidence: 99%

Cysticercosis and Epilepsy: A Critical Review

1998

View full text Add to dashboard Cite

Summary: Neurocysticercosis (NC) remains a major public health problem in developing and some developed countries. Currently, the best procedures for diagnosing NC are neuroimaging studies. Immunoserologic assays, such as enzyme-linked immunoelectrotransfer blot assay (EITB) or enzyme-linked immunosorbent assay (ELISA), detect antibodies against Taenia solium, or cysticercus. Consequently, they are useful in identifying a population at risk of contact with the parasite but do not necessarily indicate a systemic active infection. Most seropositive individuals are asymptomatic. No data from prospective studies concern the proportion of these individuals that will develop seizures or other neurologic symptoms. There is a discrepancy between the results of serologic assays and neuroimaging studies: >SO% of those individuals with NC diagnosed by computed tomography (CT) scan test EITB negative.Pathophysiologic classification of NC into active, transitional, and inactive forms permits a good correlation between clinical manifestations and neuroimaging procedures and facilitates medical and surgical management and research. The most frequent clinical manifestations of NC are seizures. We assume that NC is the main cause of symptomatic epilepsy in developing countries; however, no case-control or cohort studies demonstrate this association. Most patients with NC with seizures have a good prognosis; nevertheless, further studies analyzing factors related to recurrence of seizures and possibilities of discontinuation of antiepileptic medications (AEDs) are needed.Regarding treatment of NC with antihelminthic drugs, no controlled clinical trials exist that establish specific indications, definitive doses, and duration of treatment. The most effective approach to taeniasis/cysticercosis infection is prevention. This should be a primary public health focus for developing countries.We critically review the available information regarding the epidemiology and diagnosis of human cysticercosis, the physiopathology and imaging correlation of the parasite in the central nervous system (CNS) of the host, the relation between seizures or epilepsy and NC, and the issues surrounding the treatment and prognosis of NC, including the use of antihelminthic therapy.

show abstract

The Use of Albendazole in Patients with Single Lesions Enhanced on Contrast CT

Cited by 34 publications

References 4 publications

Prospective Quantitative Imaging Study by Magnetisation Transfer for Appearance of Perilesional Gliosis in Solitary Cerebral Cysticercal Lesion

Prospective Quantitative Imaging Study by Magnetisation Transfer for Appearance of Perilesional Gliosis in Solitary Cerebral Cysticercal Lesion

Current Consensus Guidelines for Treatment of Neurocysticercosis

Cysticercosis and Epilepsy: A Critical Review

Contact Info

Product

Resources

About