Rapid and complete resolution of giant cysticercal cysts after administration of praziquantel. A report of 4 cases.

Four patients with giant cysts, one cyst with a diameter of 55 mm, were treated with a 30-day course of praziquantel (Biltricide; Bayer-Miles) 50 mg/kg/d. One patient had corticosteroids administered simultaneously. All 4 patients had anticonvulsant cover. In all cases there was rapid and complete resolution of the cysts. In 2 patients this occurred within 30 days. The computed tomographic features of giant cysticercal cysts are: thin walled cystic lesions containing clear fluid, localised thickening of the wall (probably representing the scolex), absence of pericyst oedema, and the presence of associated smaller and more typical cysticercal larval forms. Giant cysticercal cysts resolve remarkably rapidly on medical therapy. A therapeutic trial of praziquantel can, in suspected giant cysticercal cysts, obviate the need for exploratory craniotomy.