Treatment of neurocysticercosis

Abstract

Here we put forward a roadmap that summarizes important questions that need to be answered to determine more effective and safer treatments. A key concept in management of neurocysticercosis is the understanding that infection and disease due to neurocysticercosis are variable and thus different clinical approaches and treatments are required. Despite recent advances, treatments remain either suboptimal or based on poorly controlled or anecdotal experience. A better understanding of basic pathophysiologic mechanisms including parasite survival and evolution, nature of the inflammatory response, and the genesis of seizures, epilepsy, and mechanisms of anthelmintic action should lead to improved therapies.

Spinal Neurocysticercosis Manifesting as Recurrent Aseptic Meningitis

“…Extraparenchymal lesions may or may not improve with anthelmintic treatment and, in contrast to parenchymal cysts, often need multiple courses of anthelmintics and the use of concomitant steroids; surgery may be required in life-threatening cases 14 . Complications associated with this form of NCC include meningeal inflammation, which can cause chronic meningitis and hydrocephalus; cranial nerve findings can occur as a result of granulomatous inflammation affecting nearby nerves 12 , as likely occurred in our patient.…”

“…The treatment of NCC is controversial, and remains based primarily on poorly-controlled studies or anecdotal evidence 12 . Extraparenchymal manifestations, such as those in the subarachnoid spaces, ventricles or around the spinal cord, are particularly difficult to manage as the prognosis of these patients is worse compared with those having only parenchymal disease 13 .…”

Hemorrhagic Cerebrovascular Events and Neurocysticercosis: A Case Report and Review of the Literature

“…Treatment with antihelmintics, corticosteroids, antiepileptic drugs, and surgical interventions constitute some alternatives in the management of the disease. 9 Here we report a patient who presented with a relapsed non-aneurysmal subarachnoid hemorrhage possibly associated with subarachnoid cysticercosis. In addition, we systematically reviewed the literature to summarize all of the reported cases of hemorrhagic cerebrovascular events associated with NCC.…”

Lumbar spinal intradural neurocysticercosis: A case report

“…Treatment for this disease usually includes a combination of symptomatic and cysticidal drugs. Surgical treatment of spinal neurocysticercosis is used when severe symptoms are apparent, symptom aggravation has occurred, medical treatment has failed, and acute aggravation of neurological symptoms has occurred during treatment (7).…”