RESUMO
OBJECTIVE: To determine the therapeutic efficacy of albendazole combined with surgical intervention on intracranial hypertension in the treatment of severe neurocysticercosis. METHODS: Seventy-four consecutive patients with severe neurocysticercosis were confirmed by neuroimaging techniques (CT and/or MRI) and ELISA for the detection of antibody to cysticerci of Taenia solium. The number of cysticerci in the brain ranged from 100 to 1160. All patients were treated with albendazole by dose-decreasing regimen. Initial tolerable dosage was defined by dose-decreasing progressively, depending on the total number of cysticerci; then the dose of albendazole was increased progressively, and ultimate dosage was 20 mg per kilogram of body weight daily. Albendazole was taken for 3-4 courses (10 days as a course). Drugs to reduce intracranial pressure were used in all patients during the treatment, including mannitol, corticosteroids and/or sodium escin. 67 patients with intracranial hypertension were treated with surgical treatment, including drainage of cerebral ventricle and/or decompression of temporal muscle. All patients received antiseizure medications to prevent the onset of seizures during the treatment. RESULTS: The combination of albendazole and surgical intervention was curative in 69 of 74 patients with neurocysticercosis after a follow-up of an average 37.2 (19-52) months. CT and/or MRI examination demonstrated that the cysts had disappeared or become calcified. Only 1 case failed because there were 1160 cysts in the brain of the patient. CONCLUSION: The combination of albendazole and surgical maneuvers to reduce intracranial pressure is a safe and effective method for treating severe neurocysticercosis.
