Cysticidal Therapy for Diffuse Parenchymal and Calcific Neurocysticercosis

Abstract

Antiparasitic treatment improves the prognosis for neurocysticercosis (NCC)-induced seizures. However, patients with high lesion loads are typically denied the possible benefit of cysticidal therapy because of fear of complications, and such patients are not represented in clinical trials involving cysticidal therapy. We provide proof of concept for combination treatment with dual antiparasitic therapy and corticosteroids in patients with diffuse lesions, including starry sky patterns, or calcific NCC. The safety and efficacy of treating patients with high lesion loads or calcific NCC should be tested in a randomized controlled trial.

Disseminated Cysticercosis-Should we treat?

“…2 A patient's quality of life is often poor and DCC treatment is far from satisfactory. Anecdotal reports have suggested dual antiparasitic therapy to be beneficial for treating diffuse parenchymal neurocysticerci 3 and this might be worth trying in patients with massively infiltrating DCC with concomitant corticosteroids. 4 We report two patients (a 32-year old lady and a 42-year old man) who presented with drug refractory epilepsy owing to diffuse parenchymal neurocysticercosis and, on detailed evaluation, were found to have DCC.…”

“…2 A patient's quality of life is often poor and DCC treatment is far from satisfactory. Anecdotal reports have suggested dual antiparasitic therapy to be beneficial for treating diffuse parenchymal neurocysticerci 3 and this might be worth trying in patients with massively infiltrating DCC with concomitant corticosteroids. 4…”