Combination Therapy With Albendazole and Praziquantel Versus Albendazole Alone in Children With Seizures and Single Lesion Neurocysticercosis

Abstract

A combination of albendazole and praziquantel was more effective than albendazole alone in destroying Taenia cysts in an animal model. There are no such studies in humans. To evaluate the efficacy and safety of a combination of albendazole and praziquantel in children with seizures and single small enhancing computerized tomographic lesions. Prospective, interventional, randomized, placebo-controlled, double blind clinical trial at a tertiary hospital in North India. : One hundred twelve children with seizures for <3 months and single lesion neurocysticercosis; 9 lost to follow-up. All children received albendazole (15 mg/kg/d) for 7 days with either praziquantel or placebo (75 mg/kg/d) for 1 day according to random allocation. Repeat CT scans were done after 1, 3, and 6 months. All children were followed up for at least 6 months. Fifty-three children received praziquantel (group A) and 50 placebo (group B). Complete resolution of lesions was seen in 60% and 72% of children at 3 and 6 months in group A versus 42% and 52% of children in group B. Nonresolution and calcification were higher in group B than in group A at 3 months (B: 28%, 14%; A: 12%, 8%) and 6 months (B: 16%, 22%; A: 6%, 9%), but the differences were not statistically significant. Seizure control and side effects were similar in the 2 groups. A combination therapy for albendazole and praziquantel was statistically comparable to sole therapy with albendazole in eradicating lesions and preventing seizures.