Treatment of neurocysticercosis

The clinical and laboratory data of 88 black patients with computed tomographic (CT) evidence of active neurocysticercosis were analysed. The CT appearance of neurocysticercosis was distinctive in the majority. Seizures, chronic headache and neuropsychiatric changes were the most common clinical presentations. Hydrocephalus was diagnosed in 17 patients (9 obstructive and 8 communicating) and cerebral infarction with focal neurological deficit occurred in 4 cases. All patients were treated with praziquantel (Biltricide: Bayer Miles). There was complete cyst clearance after two courses in 14 patients and in 16 cases the mean percentage reduction in cyst number was 85.88% and in cyst size 80.84%. In 1 patient there was no response to treatment. Although praziquantel was effective in parenchymal neurocysticercosis, it was ineffectual in the treatment of 5 patients with cysticercal meningitis. There were 2 deaths in the series.