Therapy for Neurocysticercosis

Takayanagui, Osvaldo Massaiti; Jardim, Edymar

doi:10.1001/archneur.1992.00530270106026

Cited by 185 publications

(32 citation statements)

References 24 publications

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“…Further studies showed that the length of therapy could be shortened to one week without lessening the efficacy of the drug [48], and even to three days if the patient has a single brain cyst [49]. Albendazole has been superior to praziquantel in trials comparing the efficacy of these drugs [50, 51]. Another advantage of albendazole is that it also destroys subarachnoid and ventricular cysts [52].…”

Section: Treatmentmentioning

confidence: 99%

Neurocysticercosis: A Review

Brutto

2012

The Scientific World Journal

164

171

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Neuroysticercosis is the most common helminthic infection of the nervous system, and a leading cause of acquired epilepsy worldwide. The disease occurs when humans become intermediate hosts of Taenia solium by ingesting its eggs from contaminated food or, most often, directly from a taenia carrier by the fecal-to-oral route. Cysticerci may be located in brain parenchyma, subarachnoid space, ventricular system, or spinal cord, causing pathological changes that are responsible for the pleomorphism of neurocysticercosis. Seizures are the most common clinical manifestation, but many patients present with focal deficits, intracranial hypertension, or cognitive decline. Accurate diagnosis of neurocysticercosis is possible after interpretation of clinical data together with findings of neuroimaging studies and results of immunological tests. The introduction of cysticidal drugs have changed the prognosis of most patients with neurocysticercosis. These drugs have shown to reduce the burden of infection in the brain and to improve the clinical course of the disease in most patients. Further efforts should be directed to eradicate the disease through the implementation of control programs against all the interrelated steps in the life cycle of T. solium, including human carriers of the adult tapeworm, infected pigs, and eggs in the environment.

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Section: Treatmentmentioning

confidence: 99%

Neurocysticercosis: A Review

Brutto

2012

The Scientific World Journal

164

171

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“…Most of the researchers administered 15 mg/kg/d of body weight of albendazole, but the duration of therapy varied from 8 days to a month [14]–[16],[18],[19]. In only one study albendazole was administered at a dosage of 20 mg/kg/d for 21 days [17]. We pooled these data, as the administration of albendazole for 7 days is as effective as for longer periods of therapy [20].…”

Section: Resultsmentioning

confidence: 99%

“…Data on the complete control of seizures in patients with neurocysticercosis treated with albendazole or praziquantel were reported in 4 out of 6 studies (Table 2) [14]–[17]. One study reported a statistically significant effects in favor of albendazole, as reported in the crude data provided in the study [17].…”

Section: Resultsmentioning

confidence: 99%

Albendazole versus Praziquantel in the Treatment of Neurocysticercosis: A Meta-analysis of Comparative Trials

et al. 2008

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BackgroundNeurocysticercosis, infection of the brain with larvae of Taenia solium (pork tapeworm), is one of several forms of human cysticercosis caused by this organism. We investigated the role of albendazole and praziquantel in the treatment of patients with parenchymal neurocysticercosis by performing a meta-analysis of comparative trials of their effectiveness and safety.Methods and Principal FindingsWe performed a search in the PubMed database, Cochrane Database of Controlled Trials, and in references of relevant articles. Six studies were included in the meta-analysis. Albendazole was associated with better control of seizures than praziquantel in the pooled data analysis, when the generic inverse variance method was used to combine the incidence of seizure control in the included trials (patients without seizures/[patients×years at risk]) (156 patients in 4 studies, point effect estimate [incidence rate ratio] = 4.94, 95% confidence interval 2.45–9.98). In addition, albendazole was associated with better effectiveness than praziquantel in the total disappearance of cysts (335 patients in 6 studies, random effects model, OR = 2.30, 95% CI 1.06–5.00). There was no difference between albendazole and praziquantel in reduction of cysts, proportion of patients with adverse events, and development of intracranial hypertension due to the administered therapy.ConclusionsA critical review of the available data from comparative trials suggests that albendazole is more effective than praziquantel regarding clinically important outcomes in patients with neurocysticercosis. Nevertheless, given the relative scarcity of trials, more comparative interventional studies—especially randomized controlled trials—are required to draw a safe conclusion about the best regimen for the treatment of patients with parenchymal neurocysticercosis.

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“…A dosage of 15 mg/kg of albendazole for 4 weeks was initially adopted, but later reduced to 15 days and then to 1 week [2]. Albendazole also destroys subarachnoid and ventricular cysts and has been associated with higher parasiticidal effects than praziquantel [8,9]. However, the majority of published studies are uncontrolled case series and there is no consensus on the most appropriate dose and timing of these antiparasitic drugs.…”

Section: Discussionmentioning

confidence: 99%

Neurocysticercosis in a 23-year-old Chinese man

et al. 2014

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Patient: Male, 23Final Diagnosis: NeurocysticerosisSymptoms: Diplopia • fever • headache • insomnia • neck stiffness • vomitingMedication: AlbendazoleClinical Procedure: —Specialty: NeurologyObjective:Challenging differential diagnosisBackground:Neurocysticercosis is a brain infection caused by the larval stage of the tapeworm Taenia (T.) solium. It is the most important parasitic disease of the human central nervous system and represents the most common cause of acquired epilepsy in developing countries.Case Report:Here, we report the case of a 23-year-old Chinese man who presented to the emergency department with a 7-day history of helmet headache radiating to the nuchal region and associated with vomiting, confusion, and fever. Cerebrospinal fluid (CSF) was clear, with increased pressure, lymphocytic pleocytosis, decreased glucose, and increased protein levels. Bacterial antigen detection test on CSF was negative, as were CSF bacterial and fungal cultures. Despite broad-spectrum antibiotic and antiviral therapy, the patient still complained of insomnia, diplopia, headache, neck stiffness, and pain in the sacral region. A second LP was performed and CSF had the same characteristics as the first LP. A brain and spinal cord MRI revealed widespread arachnoiditis and small septated cysts with CSF-like signal in the cisterna magna, within the fourth ventricle, and at the level of L3–L4. Cysticercus-specific immunoglobin G antibodies were detected by ELISA in the CSF. The patient received albendazole (15 mg/kg/day) and dexamethasone (5 mg/day) for 4 weeks, with progressive resolution of neurological symptoms.Conclusions:This case shows that, even if rare, neurocysticercosis may be responsible for meningeal symptoms and should be included in the differential diagnosis, especially in patients from endemic countries.

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Therapy for Neurocysticercosis

Cited by 185 publications

References 24 publications

Neurocysticercosis: A Review

Neurocysticercosis: A Review

Albendazole versus Praziquantel in the Treatment of Neurocysticercosis: A Meta-analysis of Comparative Trials

Neurocysticercosis in a 23-year-old Chinese man

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