Efficacy of Albendazole and Short-Course Prednisolone Treatment in Children with One or Two Ring-Enhancing Lesions of Neurocysticercosis: A Randomized Controlled Trial

A Thapalial,K Subedi,Ms Dhaliwal,Pk Swain,Rn Das

doi:10.3126/jnps.v27i2.1410

A Thapalial, K Subedi + Show 3 more

Open Access

https://doi.org/10.3126/jnps.v27i2.1410

Copy DOI

Abstract

Context: Neurocysticercosis is a endemic disease in Nepal causing social and financial burden on society and developmental problem in children. Aims: To determine the efficacy of albendazole plus oral prednisolone in children with 1 or 2 ring-enhancing lesions (by CT) on resolution of lesions and recurrence of seizure. Setting and Design: Randomized controlled open trial. Methods and Materials: Children with 1 or 2 ring-enhancing lesions < 20 mm in diameter on computed tomography scan, likely to have Neurocysticercosis, were assigned to treatment & control groups. Children assigned to the treatment group (n = 50) were given 2.0 mg/kg per day prednisolone orally for 5 days plus 15 mg/kg per day albendazole on third day for 28 days. Anti epileptic drugs were given to both groups {including Control group (n = 51)}. Statistical Analysis: The results were analysed with the use of Epi Info version 6.04 and Stata version;7 software. Results: The lesions resolved completely or partially in more children in the treated group compared with the control group (p = .04 & p = 0.03). The proportion of children who had seizures was significantly lower in the treated group compared with the control group at 6 months (10% versus 33%; p = .006) and 12 months (14% versus 38%; p = .003). Conclusion: Albendazole plus Prednisolone increased resolution of lesions on computed tomography scan and reduced the risk of subsequent recurrence of seizures among children with Neurocysticercosis. Key words: Prednisolone, Albendazole, Neurocysticercosis and Children. doi:10.3126/jnps.v27i2.1410 J. Nepal Paediatr. Soc. Vol.27(2) p.60-63

Highlights

In the developing world, Neurocysticercosis, infection of the central nervous system with Taenia solium larvae is the single most common cause of acquired epilepsy[1]
Inflammatory granulomas of the central nervous system are common in developing countries, where recent studies report that 26% to 72% of hitherto normal children with a first episode of seizure have a ring or disk enhancing lesion on computed tomography (CT)[2,3,4,5,6,7,8]
The side effects of albendazole plus prednisolone treatment and its expected efficacy were explained to parents, and their agreement to let their children participate was obtained before enrolment

Summary

Introduction

Neurocysticercosis, infection of the central nervous system with Taenia solium larvae is the single most common cause of acquired epilepsy[1]. Inflammatory granulomas of the central nervous system are common in developing countries, where recent studies report that 26% to 72% of hitherto normal children with a first episode of seizure have a ring or disk enhancing lesion on computed tomography (CT)[2,3,4,5,6,7,8]. Between the two randomized controlled trials that evaluated the efficacy of anticysticercal therapy in children with single enhancing lesions, one showed earlier resolution of CT lesions and lower seizure recurrence[20] whereas the other reported no benefit[21]. We conducted this randomized, controlled, open trial to determine the effect of albendazole plus prednisolone in children with seizures and 1 or 2 ring-enhancing lesions on resolution of the lesion as well as seizure recurrence

Objectives

Methods

Results

Conclusion