Serologic Longterm Follow-up Study in Cerebral Parenchymal Cysticercosis Patients by ELISA after Praziquantel Treatment

ABSTRACT

A total of 28 patients of confirmed cerebral parenchymal cysticercosis was followed serologically by ELISA(enzyme linked immunosorbent assay) and clinically over 1 year after praziquantel treatment. The subjects were confined to pure cerebral parenchymal form of neurocysticercosis patients in order to evaluate the effect of praziquantel on specific IgG antibody level. The main clinical features were epilepsy and headache and the brain CT showed multiple low densities, cystic rnass, nodule and calcifications. The patients included in this study were categorized into 3 groups according to the follow-up period, namely, group I (1-2 years), group II (2-3 years) and group III(over 3 years). In serum, the post-treatment(last follow-up) anti-body levels were decreased to 71% in group I, 50% in group II and 52% in group III of pre-treatment levels. Also, in CSF, the post-treatment antibody levels were decreased to 81% in group I, 71% in group II and 33% in group III of pre-treatment levels. Eight patients(2 in group I, 3 in group II, 3 in group III) showed negative conversion of IgG antibody in both serum and CSF during follow-up period. All antibody levels in serum and CSF were expected to decline below negative range around 56-57 months after praziquantel treatment by simple linear regression analysis. However, in CSF, it took about 66-67 months for high pre-treatrnent titer patients above 0.8 to convert into negative range and about 34-35 rnonths for low pre-treatrnent titer ones below 0.8. In conclusion. It might be possible to differentiate serologically the early cured from the chronically ill patients uith slowly calcifying lesion by ELISA in neurocysticercosis,which would be also helpful to determine the next treatment modality.