[Successful treatment of cerebral cysticercosis with praziquantel]

A case of a 56-year-old Korean man with cerebral cysticercosis was reported. This case demonstrated the first successful treatment with praziquantel in Japan and also the usefulness of a low-dose regime in the treatment of cerebral cysticercosis. The patient was admitted to our hospital with a 7 years history of generalized seizure and a 6 months history of gait disturbance. He had 6 subcutaneous nodules. A CT scan of the brain showed multiple cysts containing a small calcification and the largest lesion measured 5 cm in diameter in the cerebellar vermis. Posterior fossa craniectomy was performed and the cyst was pathologically confirmed as cysticercosis. A month postoperatively the patient was given praziquantel 50 mg/kg body weight in 3 divided doses per day. But medication with praziquantel was stopped on the 5th day because of severe headache, nausea and vomiting. He was readmitted 6 months later with appearance of gait disturbance, left facial paresis and dysphagia. A CT scan revealed enlargement of some of the residual cysts. The patient was then given smaller doses of praziquantel 8 mg/kg body weight in 3 divided doses with steroid cover for 48 days. He experienced no side effect during the therapy and became free from the neurological symptoms. A CT scan showed complete disappearance and only numerous small calcifications of the cysts.