Praziquantel is the treatment of choice (this is not licenced in the UK). Advice should be sought from an expert in infectious diseases.
Surgical excision of the cysticerci may be required.
Neurocysticercosis management
- two anthelmintic medications are used for the management of neurocysticercosis: praziquantel and albendazole
- anthelmintics were previously considered only for people with viable cysts, with the aim of killing the live parasites
- however, expert guidance present a stronger recommendation for using anthelmintics for both viable and non-viable cysts, unless diffuse cerebral oedema or hydrocephalus are present
- if anthelmintics are used, corticosteroids are often prescribed to prevent inflammation of the brain caused by the host immune response to the co-ordinated death of multiple parasites
- a systematic review concluded that treatment with albendazole probably increases complete clearance of lesions on brain imaging as well as the evolution of cysts (from viable to non-viable to resolved or calcified) (moderate-certainty evidence) (1)
- found very little information regarding praziquantel, therefore these results are apply to albendazole only
Reference
- Monk EJM, Abba K, Ranganathan LN. Anthelmintics for people with neurocysticercosis. Cochrane Database of Systematic Reviews 2021, Issue 6. Art. No.: CD000215. DOI: 10.1002/14651858.CD000215.pub5.