RT Journal Article
SR Electronic
T1 Drug therapy for solitary cysticercus granuloma
JF Neurology
JO Neurology
FD Lippincott Williams & Wilkins
SP 152
OP 162
DO 10.1212/WNL.0b013e31827b90a8
VO 80
IS 2
A1 Willem M. Otte
A1 Monika Singla
A1 Josemir W. Sander
A1 Gagandeep Singh
YR 2013
UL http://n.neurology.org/content/80/2/152.abstract
AB Objective: The effectiveness of anthelminthic and corticosteroid drug therapy in parenchymal neurocysticercosis is well established. The treatment of parenchymal solitary cysticercus granuloma (SCG), however, remains controversial. We attempted to obtain a consistent estimate of the efficacy of anthelminthic and corticosteroid drug treatment in SCG.Methods: Randomized-controlled trials (RCTs) comparing rates of seizure freedom, granuloma resolution, and residual calcification in individuals with SCG treated with anthelminthic or corticosteroid drugs with those treated with antiepileptic drugs (AEDs) alone were systematically reviewed and quantified using fixed- or random-effects meta-analysis.Results: Fifteen RCTs were identified for inclusion. Ten RCTs assigned 765 people with SCG to AED treatment with or without anthelminthic drug (albendazole) treatment. A further 5 RCTs assigned 457 people with SCG to AED treatment with or without corticosteroid drugs. Anthelminthic treatment was associated with significantly increased rates of seizure freedom (nonevent odds ratio: 2.45; 95% confidence interval: 1.49–4.03; p = 0.0004) and significantly higher rates of granuloma resolution (odds ratio: 2.09; 95% confidence interval: 1.41–3.00; p = 0.0003), but did not alter the risk of residual calcification. Corticosteroid treatment was not significantly associated with any outcome.Conclusions: Anthelminthic treatment with albendazole provides improved rates of seizure freedom and hastens resolution of the granuloma. The role of corticosteroid treatment remains uncertain. The benefits (or lack thereof in the case of corticosteroids) are consistent when measured across different time points after treatment.AED=antiepileptic drug; CI=confidence interval; OR=odds ratio; RCT=randomized-controlled trial; SCG=solitary cysticercus granuloma