Therapy for neurocysticercosis. Comparison between albendazole and praziquantel

Praziquantel and albendazole have been recently described as effective drugs for treatment of intraparenchymal brain cysticercosis. We performed a prospective study comparing the efficacy of these drugs. Twenty-two patients were treated with praziquantel and 21 with albendazole. In addition, 16 patients were treated with symptomatic drugs only and used as controls. Treatment was discontinued in two patients receiving praziquantel and one patient receiving albendazole owing to acute decompensation of the increased intracranial pressure, and one of them died. Albendazole and praziquantel were effective when compared with the control group. However, albendazole was significantly more effective than praziquantel in reducing the total number of cysts in the computed tomographic scans (88% vs 50%). Despite these results, however, analysis of clinical course showed a high frequency of neurologic sequelae. Considering the risks and fallibility of anticysticercal therapy, the real solution for this serious disease continues to be prophylaxis of infestation.