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Smaller cysts in the subarachnoid space have been shown to respond to antihelminthic therapy (12) and even dramatic remission has been described for giant (>50 mm) cysts.
There are reports of successful treatment of ventricular cysts with antihelminthic medication (39,42,43) and other reports that are not as promising.
Is the course of neurocysticercosis modified by treatment with antihelminthic agents?
Antihelminthic therapy including praziquantel (50 mg/kg/d in divided doses for 14 days) and albendazole (15 mg/kg/d for 1 month) has been the mainstay of treatment for parenchymal neurocysticercosis.
Praziquantel is an isoquinolone with a broad antihelminthic activity (Sotelo et al.
If dexamethasone is used, it affects the serum concentrations of the antihelminthic therapy when albendazole is given concomitantly with dexamethasone, the serum and CSF metabolite concentrations are increased by up to 50% (Jung, Hurtado, Medina, Sanchez, & Sotelo, 1990), whereas the plasma levels of praziquantel decrease 50% when given dexamethasone simultaneously (Vazquez, Jung, & Sotelo, 1987).
Considerations on deciding whether to initiate antihelminthic therapy once a diagnosis of neurocysticercosis has been established should include the number of cysts present, whether the cysts are viable or calcified, and whether the patient is symptomatic or asymptomatic.
Patients being treated with antihelminthic medications need to be monitored closely for signs of increased intracranial pressure, because hydrocephalus is a common side effect of the medication.