Abstract
Objective: To review the evidence base for different treatment strategies in intraparenchymal neurocysticercosis in adults and children.
Method: 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.
Results: 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.
Recommendations: 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).
Footnotes
Appendices e-1 through e-8 and the e-tables are available as data supplements on the Neurology® website at www.neurology.org.
Accepted for publication by the Guideline Development Subcommittee on July 14, 2012; by the Practice Committee on July 24, 2012; and by the AAN Board of Directors on December 26, 2012.
Go to Neurology.org for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.
- Received August 3, 2012.
- Accepted in final form December 14, 2012.
- © 2013 American Academy of Neurology
Disputes & Debates: Rapid online correspondence
- The role of a systematic review
- Author response to Burneo et al. correspondence
- Response to Carpio et al. correspondence
- Guideline on treatment of neurocysticercosis: some observations
- Authors' response to Sethi and Gonzalez-Duarte correspondence
- Treatment of Parenchymal Neurocysticercosis (NCC): Guideline Concerns
- Treatment of parenchymal neurocysticercosis
REQUIREMENTS
If you are uploading a letter concerning an article:
You must have updated your disclosures within six months: http://submit.neurology.org
Your co-authors must send a completed Publishing Agreement Form to Neurology Staff (not necessary for the lead/corresponding author as the form below will suffice) before you upload your comment.
If you are responding to a comment that was written about an article you originally authored:
You (and co-authors) do not need to fill out forms or check disclosures as author forms are still valid
and apply to letter.
Submission specifications:
- Submissions must be < 200 words with < 5 references. Reference 1 must be the article on which you are commenting.
- Submissions should not have more than 5 authors. (Exception: original author replies can include all original authors of the article)
- Submit only on articles published within 6 months of issue date.
- Do not be redundant. Read any comments already posted on the article prior to submission.
- Submitted comments are subject to editing and editor review prior to posting.