Tratamiento de la neurocisticercosis: revisión critica / Treatment of neurocysticercosis: a review

Neurocysticercosis (NCC) is the most common parasitic disease of the central nervous system. Several drugs, such as drugs against tapeworms, praziquantel or albendazole associated to corticosteroids, have been tested for the treatment of this condition. Although some have claimed the reduction or involution of cystic or granulomatous lesions, there is no consensus about the efficacy of these treatments. The natural evolution of the disease is not clear and this hampers the assessment of treatment effects. Moreover, there are no good imaging or clinical indicators that can predict the progression or spontaneous resolution of lesions, specially at the meningeal or ventricular compartment. Therefore, evidence based medicine does not have a definitive answer about the treatment, neither of seizures, the most common manifestation of NCC, or the varied and complex meningeal and ventricular involvement. This review includes experts opinions to give the clinician some clues for decision making in the treatment of NCC.

Study on human taeniasis by administering anti-taenia drug

Mazandaran province, northern Iran, has been an area with highest prevalence of infectivity with human taeniasis during past decades. In order to assess current situation of taeniasis in the province by a method which can yield a correct estimation of infection rate, this study was performed by administrating anti-Taenia drug, during 2003-2004. A total of 417 people were randomly selected from rural areas of Mazandaran province. All of them were at first given a dose of niclosamide [2-4 500 mg tablets] and bisacodile [1-3 5 mg tablets]; then their 36 h stool passage was collected and examined macroscopically and microscopically. The results revealed that 2 individuals [0.5%] were infected with Taenia saginata. Compared with previous decades, there is a sharp drop on human taeniasis in the study area. Infected peoples were followed up till complete treatment

Un caso de probable neurocisticercosis en un lactante / Probable neurocysticercosis in an infant

La cisticercosis es la parasitosis que más frecuentemente compromete el sistema nervioso central y su prevalencia está estrictamente relacionada con el saneamiento ambiental. Se presenta habitualmente en adultos de edad media, siendo infrecuente su aparición en la edad pediátrica. Su aspecto clínico varía desde cuadros asintomáticos hasta las manifestaciones de diversos cuadros neurológicos, por lo cual su diagnóstico no es fácil y debe complementarse con técnicas de imágenes y serología específica. Presentamos el caso de un lactante que consultó por una hemiplejía de instalación aguda y en cuya tomografía axial computarizada cerebral mostró múltiples imágenes granulomatosas, planteándonos un problema de diagnóstico diferencial con lesiones de etiología bacteriana; se logró un acercamiento diagnóstico gracias al estudio epidemiológico de su grupo familiar

Efficacy and safety of mebendazole in children with worm infestation

Children aged between 2-16 years, were screened for worm infestation. Fifty-five children fulfilling the inclusion criteria were included in the study. They were treated with mebendazole 100 mg twice daily for three consecutive days and followed-up for 15 days to assess cure rate and side effects. Fifty children completed the study with their stools being tested by direct smear and concentration methods and blood CBC done before treatment and at the end of the study. The cure rate for ascaris was 100% and for trichuris 75%. The drug was well tolerated and apart from mild diarrhoea occurring in 22% children, no untoward effects were reported. Nemazole [mebendazole] has shown promise and seems useful in treating children with worm infestation

Neurocisticercosis / Neurocysticercosis

La neurocisticercosis es la parasitosis del sistema nervioso central (SNC) producida por la forma larval de la taenia solium. En 1950 Parnolus encontró un cisticerco en el cuerpo calloso, pero sólo en 1985 Kuchen Meister asoció afección con la taenia solium. La forma muscular fue descubierta por primera vez por Priets en 1926 y subsecuentemente también la comunicaron M Gill, Jacob y Mathews. En Estados Unidos la neurocisticercosis se describió por primera vez en 1927 por Walter Dandy

Methyl 5(6)-(alpha-hydroxyphenyl methyl) benzimidazole-2-carbamate and cysticercosis: chemotherapeutic and electron microscopic studies.

Methyl 5(6)-(alpha-hydroxyphenyl methyl) benzimidazole-2-carbamate, a major metabolite of mebendazole was evaluated against Cysticercus fasciolaria (larval form of Taenia taeniaeformis) in rats. The metabolite was assessed in various doses. A regimen of 50 mg/kg x 10 (ip), given one day apart, was found to be most effective and killed all the mature cysticerci. On developing cysts, the treatment was initiated in two schedules; 5 days prior to (d-5 to d-1) and 5 days after (d + 6 to d + 10) administration of T. taeniaeformis eggs to rats. The later protocol with 100 mg/kg x 5 dose (ip) resulted in 95% inhibition in the establishment of cysticerci. Activity of mebendazole against mature cysts was parallel to metabolite whereas against developing cysts, it was inferior. The time related topographical changes that occurred in mature C. fasciolaris after treatment with metabolite (50 mg/kg x 10, ip, one day apart) were observed by scanning electron microscopy. There was loss of contractivity, gradual disappearance of microtriches and progressive degeneration of tegument. Similar changes were noticed with mebendazole. The possession of better efficacy and higher safety range [Indian J Exp. Biol, 25 (1987) 871], suggests that the metabolite can be a potential anthelmintic for man and animals.