Update in neurocysticercosis treatment

Introduction. Neurocysticercosis is the most frequent central nervous system parasitosis, although quite infrequent in our country. Its rising incidence can be explained by immigration from regions of the world where this disease is endemic. Objective. This paper reviews treatment options for this condition. Patients and methods. Eight patients have been diagnosed with neurocysticercosis in the last three years in our hospital. Patient age sex, origin, symptoms, CT and MR images, diagnostic tests, treatment and duration of medical treatment and clinical and neuroradiological evolution are examined. Results. Patient age ranged from 25 to 33years, all eight came from South America and the most frequent initial symptom was an epileptic crisis. Two patients had a single lesion, six had multiple lesions and all eight showed the lesion in the parenchyma. Only 50% showed a positive serum ELISA test for Taenia solium. Initial treatment was surgical in only one patient and the other seven received albendazol. In one of the latter the drug was ineffective and surgery was undertaken. A ten month follow up period has found a favorable evolution in all the patients, who are all also asymptomatic at the present time. Discussion and conclusions. Neurocysticercosis is more common among immigrants than the local population in Spain. The initial treatment should be medical, with surgery as an option for non-responders. We believe that duration of the medical treatment will depend on the patient and the clinico-radiological evolution of his/her disease.