Outcomes of medical treatment of neurocysticercosis: a study of 65 cases in Cheju Island, Korea

Abstract

BACKGROUND Although cysticidal drugs hasten the death and disappearance of the parasite, the long-term prognosis of NCC is still not satisfactory. METHODS In this study, 65 patients with active neurocysticercosis (NCC) treated with praziquantel or albendazole were retrospectively reviewed to evaluate radiological and clinical outcome. According to worm location, patients were divided into two groups: parenchymal ( n = 42) and extraparenchymal NCC ( n = 23). The average duration of follow-up was 23 months. RESULTS In terms of cysticidal effectiveness (73% vs. 50%), seizure control (60% vs. 43%) and symptomatic improvement of non-seizure patients (64% vs. 44%), the outcome of treatment was better in the parenchymal NCC than in the extraparenchymal. Repeated cysticidal treatment was needed in 26% of parenchymal and 39% of extraparenchymal NCC. After treatment, 38% of parenchymal NCC complained of seizure and 35% suffered from headache. Likewise, 27% and 36% of extraparenchymal NCC complained of seizure and headache, respectively. During the follow-up, 7 of 30 patients without initial seizure developed new seizures after medical treatment. CONCLUSION Despite the development of cysticidal drugs, a considerable number of patients suffer from late neurologic sequelae such as seizure and headache. Therefore continuous attention should be given to the patients after cysticidal treatment. Prevention by health education is emphasized.