Clinical evaluation of albendazole and praziquantel in the treatment of cerebral cysticercosis.

One hundred consecutive patients presenting with symptoms and signs of neurocysticercosis, confirmed by neuroimaging techniques were randomly assigned to treatment with either praziquantel 50 mg/kg/day for 15 days or albendazole 15 mg/kg/day for 30 days. All patients were treated also with steroids for 42 days. Follow-up was for 90 days for response to treatment and for at least 1 year for recurrence. Although similar numbers of patients showed no improvement in neuroimaging criteria at 3 months, the response to albendazole was more pronounced with larger numbers showing marked improvement or disappearance of lesions. Similar findings were apparent, with resolution of the presenting neurological signs and symptoms being more frequent, in the albendazole group. Electroencephalographic changes were also normalized. The use of steroids eliminated the frequently observed headache that has been seen during the first few days of treatment and permitted severe cases to be treated. Both albendazole and praziquantel appear to be effective at the doses used, with albendazole showing a slightly better overall response.