Medical management of neurocysticercosis

Expert Opin Pharmacother. 2011 Dec;12(18):2845-56. doi: 10.1517/14656566.2011.634801. Epub 2011 Nov 15.

Abstract

Introduction: Neurocysticercosis (NCC) is considered to be the most common cause of acquired epilepsy worldwide. Formerly restricted to palliative measures, therapy for NCC has advanced with the advent of two drugs that are considered to be effective: praziquantel (PZQ) and albendazole (ALB).

Areas covered: All available articles regarding research related to the treatment of NCC were searched. Relevant articles were then reviewed and used as sources of information for this review.

Expert opinion: Anticysticercal therapy has been marked by intense controversy. Recent descriptions of spontaneous resolution of parenchymal cysticercosis with benign evolution, risks of complications and reports of no long-term benefits have reinforced the debate over the usefulness and safety of anticysticercal therapy. High interindividual variability and complex pharmacological interactions will require the close monitoring of plasma concentrations of ALB and PZQ metabolites in future trials. Given the relative scarcity of clinical trials, more comparative interventional studies - especially randomized controlled trials in long-term clinical evolution - are required to clarify the controversy over the validity of parasitic therapy in patients with NCC.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Albendazole / administration & dosage
  • Albendazole / adverse effects
  • Albendazole / blood
  • Albendazole / therapeutic use*
  • Animals
  • Anthelmintics / administration & dosage
  • Anthelmintics / adverse effects
  • Anthelmintics / blood
  • Anthelmintics / therapeutic use*
  • Brain Diseases / complications
  • Brain Diseases / drug therapy*
  • Brain Diseases / parasitology
  • Brain Diseases / surgery
  • Humans
  • Life Cycle Stages / drug effects
  • Magnetic Resonance Imaging
  • Neurocysticercosis / complications
  • Neurocysticercosis / drug therapy*
  • Neurocysticercosis / parasitology
  • Neurocysticercosis / surgery
  • Praziquantel / administration & dosage
  • Praziquantel / adverse effects
  • Praziquantel / blood
  • Praziquantel / therapeutic use*
  • Seizures / etiology
  • Seizures / prevention & control
  • Taenia solium / drug effects
  • Taenia solium / physiology

Substances

  • Anthelmintics
  • Praziquantel
  • Albendazole