Evidence-based guideline: Treatment of parenchymal neurocysticercosis: Report of the Guideline Development Subcommittee of the American Academy of Neurology

Neurology (Impact Factor: 8.29). 04/2013; 80(15):1424-1429. DOI: 10.1212/WNL.0b013e31828c2f3e


To review the evidence base for different treatment strategies in intraparenchymal neurocysticercosis in adults and children.

A literature search of Medline, EMBASE, LILACS, and the Cochrane Database from 1980 to 2008, updated in 2012, resulted in the identification of 10 Class I or Class II trials of cysticidal drugs administered with or without corticosteroids in the treatment of neurocysticercosis.

The available data demonstrate that albendazole therapy, administered with or without corticosteroids, is probably effective in decreasing both long-term seizure frequency and the number of cysts demonstrable radiologically in adults and children with neurocysticercosis, and is well-tolerated. There is insufficient information to assess the efficacy of praziquantel.

Albendazole plus either dexamethasone or prednisolone should be considered for adults and children with neurocysticercosis, both to decrease the number of active lesions on brain imaging studies (Level B) and to reduce long-term seizure frequency (Level B). The evidence is insufficient to support or refute the use of steroid treatment alone in patients with intraparenchymal neurocysticercosis (Level U).

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    • "Both diagnosis and prognosis of neurocysticercosis cases depend heavily on parasite location. When parasites are located intraparenchymally or in the subarachnoid space of the convexity, diagnosis is relatively straightforward by using computed tomography or Magnetic Resonance Imaging (MRI) and prognosis is generally good, since cestocidal drugs (albendazole or praziquantel ) are useful in most cases (Baird et al., 2013). The occurrence of seizures is the most common symptom. "
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