Albendazole therapy for neurocysticercosis: a prospective double-blind trial comparing 7 versus 14 days of treatment. Cysticercosis Working Group in Peru.

OBJECTIVE

To compare the effectiveness of two regimens of albendazole therapy for neurocysticercosis.

DESIGN

Randomized, double-blind clinical trial.

SETTINGS: Patients admitted to neurologic wards in Lima, Peru.

PATIENTS: Adult patients with active neurocysticercosis demonstrated by CT and Western blot (immunoblot).

INTERVENTION: One week (n = 25) versus 2 weeks (n = 25) of albendazole therapy.

MEASUREMENTS: Decrease in the number of cysts on CT.

RESULTS

Effectiveness of albendazole was 78%, with no difference between the groups when compared 3 months after therapy. Complete cure was obtained in only 38% of patients. Patients with more than 20 cysts had poorer responses to therapy. The clinical course and EEG evolution improved in most patients. Side effects were present in 38% of patients, mainly mild, transient gastrointestinal symptoms. Therapy was also associated with exacerbation of neurologic symptoms. Two patients died in the first year after therapy, both because of aggregated infections of ventricle-peritoneal shunts. One-year follow-up CT showed lesions in three of 10 patients presumed to be cured 3 months after therapy.

CONCLUSIONS

Extension of albendazole therapy for more than 7 days adds no benefits for the patients.