Neurocysticercosis

Patients with brain cysts (neurocysticercosis) often present with seizures requiring antiepileptic therapy. In patients with active cysts, systematic reviews found that the use of albendazole with or without concomitant corticosteroids reduces long-term seizure frequency and the number of active lesions. There is insufficient evidence on the efficacy of corticosteroids alone, and consensus is now that albendazole together with corticosteroids is the preferred therapy. A small randomised controlled trial supports the addition of praziquantel to albendazole and corticosteroids1; this combination is recommended for patients with more than two viable parenchymal cysticerci2. Patients with calcified cysts but no active cysts do not require cysticidal drug therapy. Seek expert advice.

1 Garcia HH, Gonzales I, Lescano AG, Bustos JA, Zimic M, Escalante D, et al. Efficacy of combined antiparasitic therapy with praziquantel and albendazole for neurocysticercosis: a double-blind, randomised controlled trial. Lancet Infect Dis 2014;14(8):687-95.http://www.ncbi.nlm.nih.gov/pubmed/24999157Return
2 White AC, Jr., Coyle CM, Rajshekhar V, Singh G, Hauser WA, Mohanty A, et al. Diagnosis and treatment of neurocysticercosis: 2017 Clinical practice guidelines by the Infectious Diseases Society of America (IDSA) and the American Society of Tropical Medicine and Hygiene (ASTMH). Clin Infect Dis 2018;66(8):1159-63.http://www.ncbi.nlm.nih.gov/pubmed/29617787Return