[Neurocysticercosis. II. Evaluation of treatment with praziquantel]

The results of the use of praziquantel (PZQ) for the etiologic treatment of neurocysticercosis (NC) are presented. The drug was administered to 45 patients (24 women and 21 men) at increasing doses of 10 to 50 mg/kg/day during the first week and with maintenance on the last dose for two additional weeks, preferentially for patients that presented intraparenchymatous cystic lesions in the computed axial tomography. Follow-up ranged from 8 months to 4 years and a half (median, 2.7 years). During PZQ administration 27 patients (60%) presented side effects which required interruption of treatment in three cases. Decompensation of the increased ICP occurred in two cases (one of them fatal). Exacerbation of CSF pleocytosis occurred in 26 patients (57.7%). Evaluation of the results of PZQ treatment showed a lower clinical-laboratory rate of success than reported in the literature. The most appropriate indications for the use of PZQ are discussed on the basis of the present data and of reports by other investigators. In view of the risks and fallibility of treatment with PZQ, the solution of NC resides in the prevention of infestation.