Albendazole versus praziquantel in the treatment of cerebral cysticercosis: clinical evaluation

Abstract

One hundred consecutive patients presenting with symptoms and signs of neurocysticercosis, confirmed by neuroimaging techniques, were randomly assigned to treatment with either praziquantel 50 mg/kg/d for 15 d or albendazole 15 mg/kg/d for 30 d. All patients were treated in addition with steroids for 45 d. Follow-up was for 90 d for response to treatment and at least 1 year for recurrence. Although similar numbers of patients showed no improvement in neuroimaging criteria at 3 months, the response to albendazole was more pronounced with larger numbers showing marked improvement or disappearance of lesions. Resolution of the presenting neurological signs and symptoms was also more frequent in the albendazole group. Electroencephalographic changes also became normal. The use of steroid cover eliminated the headache frequently present during the first few days of treatment and permitted severe cases to be treated. Both albendazole and praziquantel appeared to be effective at the doses used, with albendazole showing a slightly better overall response.