OBJECTIVE: Fifteen-day praziquantel therapy for parenchymal neurocysticercosis has been shown to be effective. Plasma and cerebrospinal fluid concentrations of praziquantel peak two hours after administration. Maintenance of high concentrations of the drug for six hours may be an adequate therapy for the disease. METHODS: Thirty patients with parenchymal neurocysticercosis were treated with three oral doses of praziquantel(25 mg/kg) at two-hour intervals. Intramuscular dexamethasone (10 mg/day) was administered for three days after the praziquantel treatment. RESULTS: Cysts disappeared in 21 patients and showed a decrease in number of 30 to 60% in seven patients. Two patients remained without change. Considering the total number of cysts, this therapy showed a 70.7% eradication rate. Two patients had seizures, six reported headache, and nausea was frequently reported. Patients under antiepileptic treatment did not have seizures. CONCLUSION: The cost and duration of treatment with praziquantel were significantly reduced and the inflammation that follow the destruction of the parasite was treated sequentially.
OBJECTIVE: Fifteen-day praziquantel therapy for parenchymal neurocysticercosis has been shown to be effective. Plasma and cerebrospinal fluid concentrations of praziquantel peak two hours after administration. Maintenance of high concentrations of the drug for six hours may be an adequate therapy for the disease. METHODS: Thirty patients with parenchymal neurocysticercosis were treated with three oral doses of praziquantel(25 mg/kg) at two-hour intervals. Intramuscular dexamethasone (10 mg/day) was administered for three days after the praziquantel treatment. RESULTS: Cysts disappeared in 21 patients and showed a decrease in number of 30 to 60% in seven patients. Two patients remained without change. Considering the total number of cysts, this therapy showed a 70.7% eradication rate. Two patients had seizures, six reported headache, and nausea was frequently reported. Patients under antiepileptic treatment did not have seizures. CONCLUSION: The cost and duration of treatment with praziquantel were significantly reduced and the inflammation that follow the destruction of the parasite was treated sequentially.
Authors: Hector H García; Carlton A W Evans; Theodore E Nash; Osvaldo M Takayanagui; A Clinton White; David Botero; Vedantam Rajshekhar; Victor C W Tsang; Peter M Schantz; James C Allan; Ana Flisser; Dolores Correa; Elsa Sarti; Jon S Friedland; S Manuel Martinez; Armando E Gonzalez; Robert H Gilman; Oscar H Del Brutto Journal: Clin Microbiol Rev Date: 2002-10 Impact factor: 26.132