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::* 2. '''Parenchymal neurocysticercosis'''
::* 2. '''Parenchymal neurocysticercosis'''
:::* 2.1 '''Patients body weight of ≥60 kg'''
:::* 2.1 '''Patients body weight of ≥60 kg'''
::::* Preferred regimen: [[Albendazole]] 400 mg PO bid {{and}} [[Dexamethasone]] 0.1 mg/kg/day with or without anti-seizure medication all for 8-30 days  
::::* Preferred regimen: [[Albendazole]] 400 mg PO bid {{and}} [[Dexamethasone]] 0.1 mg/kg/day PO with or without anti-seizure medication all for 8-30 days  
:::* 2.2  '''Patients body weight of 60 kg'''
:::* 2.2  '''Patients body weight of 60 kg'''
::::* Preferred regimen: [[Albendazole]] 15 mg/kg/day PO bid (max. 800 mg/day) {{and}} [[Dexamethasone]] 0.1 mg/kg/day with or without anti-seizure medication] all for 8-30 days  
::::* Preferred regimen: [[Albendazole]] 15 mg/kg/day PO bid (max. 800 mg/day) {{and}} [[Dexamethasone]] 0.1 mg/kg/day PO with or without anti-seizure medication] all for 8-30 days  
::::* Alternative regimen: ([[Praziquantel]] 100 mg/kg per day PO tid for 1 day, then 50 mg/kg/day tid {{and}} [[Dexamethasone]] 0.1mg/kg per day with or without anti-seizure medication) all for 29 days.
::::* Alternative regimen: ([[Praziquantel]] 100 mg/kg per day PO tid for 1 day, then 50 mg/kg/day tid {{and}} [[Dexamethasone]] 0.1mg/kg per day with or without anti-seizure medication) all for 29 days.
::::* Note (1): [[Albendazole]] associated with 46% decrease in seizures.
::::* Note (1): [[Albendazole]] associated with 46% decrease in seizures.
Line 16: Line 16:
::* 3. '''Degenerating cysts'''
::* 3. '''Degenerating cysts'''
:::* 3.1 '''Patients body weight of ≥60 kg'''
:::* 3.1 '''Patients body weight of ≥60 kg'''
::::* Preferred regimen: [[Albendazole]] 400 mg PO bid {{and}} [[Dexamethasone]] 0.1 mg/kg/day with or without anti-seizure medication all for 8-30 days  
::::* Preferred regimen: [[Albendazole]] 400 mg PO bid {{and}} [[Dexamethasone]] 0.1 mg/kg/day PO with or without anti-seizure medication all for 8-30 days  
:::* 3.2  '''Patients body weight of 60 kg'''
:::* 3.2  '''Patients body weight of 60 kg'''
::::* Preferred regimen: [[Albendazole]] 15 mg/kg/day PO bid (max. 800 mg/day) {{and}} [[Dexamethasone]] 0.1 mg/kg/day with or without anti-seizure medication] all for 8-30 days  
::::* Preferred regimen: [[Albendazole]] 15 mg/kg/day PO bid (max. 800 mg/day) {{and}} [[Dexamethasone]] 0.1 mg/kg/day PO with or without anti-seizure medication] all for 8-30 days  
::::* Alternative regimen: ([[Praziquantel]] 100 mg/kg per day PO tid for 1 day, then 50 mg/kg/day tid {{and}} [[Dexamethasone]] 0.1mg/kg per day with or without anti-seizure medication) all for 29 days.
::::* Alternative regimen: ([[Praziquantel]] 100 mg/kg per day PO tid for 1 day, then 50 mg/kg/day tid {{and}} [[Dexamethasone]] 0.1mg/kg/day PO with or without anti-seizure medication) all for 29 days.
::::* Note (1): Treatment improves prognosis of associated seizures.  
::::* Note (1): Treatment improves prognosis of associated seizures.  
::::* Note (2): For '''dead calcified cysts''', no treatment indicated
::::* Note (2): For '''dead calcified cysts''', no treatment indicated
::* 4. '''Subarachnoid neurocysticercosis'''
::* 4. '''Subarachnoid neurocysticercosis'''
:::* 4.1 '''Patients body weight of ≥60 kg'''
:::* 4.1 '''Patients body weight of ≥60 kg'''
::::* Preferred regimen: [[Albendazole]] 400 mg PO bid {{and}} [[Dexamethasone]] 0.1 mg/kg/day with or without anti-seizure medication all for 8-30 days  
::::* Preferred regimen: [[Albendazole]] 400 mg PO bid {{and}} [[Dexamethasone]] 0.1 mg/kg/day PO with or without anti-seizure medication all for 8-30 days  
:::* 4.2  '''Patients body weight of 60 kg'''
:::* 4.2  '''Patients body weight of 60 kg'''
::::* Preferred regimen: [[Albendazole]] 15 mg/kg/day PO bid (max. 800 mg/day) {{and}} [[Dexamethasone]] 0.1 mg/kg/day with or without anti-seizure medication] all for 8-30 days  
::::* Preferred regimen: [[Albendazole]] 15 mg/kg/day PO bid (max. 800 mg/day) {{and}} [[Dexamethasone]] 0.1 mg/kg/day PO with or without anti-seizure medication] all for 8-30 days  
::::* Alternative regimen: ([[Praziquantel]] 100 mg/kg per day PO tid for 1 day, then 50 mg/kg/day tid  {{and}} [[Dexamethasone]] 0.1mg/kg per day with or without anti-seizure medication) all for 29 days.
::::* Alternative regimen: ([[Praziquantel]] 100 mg/kg per day PO tid for 1 day, then 50 mg/kg/day tid  {{and}} [[Dexamethasone]] 0.1mg/kg/day PO with or without anti-seizure medication) all for 29 days.
::::*  Note: Shunting for hydrocephalus, as without shunt, 50% of patients died within 9 years.
::::*  Note: Shunting for hydrocephalus, as without shunt, 50% of patients died within 9 years.
::* 5. '''Intraventricular neurocysticercosis'''
::* 5. '''Intraventricular neurocysticercosis'''
:::* 5.1 '''Patients body weight of ≥60 kg'''
:::* 5.1 '''Patients body weight of ≥60 kg'''
::::* Preferred regimen: [[Albendazole]] 400 mg PO bid {{and}} [[Dexamethasone]] 0.1 mg/kg/day with or without anti-seizure medication all for 8-30 days  
::::* Preferred regimen: [[Albendazole]] 400 mg PO bid {{and}} [[Dexamethasone]] 0.1 mg/kg/day PO with or without anti-seizure medication all for 8-30 days  
:::* 5.2  '''Patients body weight of 60 kg'''
:::* 5.2  '''Patients body weight of 60 kg'''
::::* Preferred regimen: [[Albendazole]] 15 mg/kg/day PO bid (max. 800 mg/day) {{and}} [[Dexamethasone]] 0.1 mg/kg/day with or without anti-seizure medication] all for 8-30 days  
::::* Preferred regimen: [[Albendazole]] 15 mg/kg/day PO bid (max. 800 mg/day) {{and}} [[Dexamethasone]] 0.1 mg/kg/day PO with or without anti-seizure medication] all for 8-30 days  
:::*  Alternative regimen: ([[Praziquantel]] 100 mg/kg per day PO tid for 1 day, then 50 mg/kg/day tid {{and}} [[Dexamethasone]] 0.1mg/kg per day with or without anti-seizure medication) all for 29 days
:::*  Alternative regimen: ([[Praziquantel]] 100 mg/kg per day PO tid for 1 day, then 50 mg/kg/day tid {{and}} [[Dexamethasone]] 0.1mg/kg/day PO with or without anti-seizure medication) all for 29 days
:::* Note: Neuroendoscopic removal if obstruction of CSF circulation.
:::* Note: Neuroendoscopic removal if obstruction of CSF circulation.


Revision as of 18:48, 22 July 2015

Neurocysticercosis

  • Neurocysticercosis treatment (NCC)[1]
  • 1. Larval form of Taenia solium
  • Preferred regimen: Praziquantel 5-10 mg/kg PO for single dose for children & adults.
  • 2. Parenchymal neurocysticercosis
  • 2.1 Patients body weight of ≥60 kg
  • Preferred regimen: Albendazole 400 mg PO bid AND Dexamethasone 0.1 mg/kg/day PO with or without anti-seizure medication all for 8-30 days
  • 2.2 Patients body weight of 60 kg
  • Preferred regimen: Albendazole 15 mg/kg/day PO bid (max. 800 mg/day) AND Dexamethasone 0.1 mg/kg/day PO with or without anti-seizure medication] all for 8-30 days
  • Alternative regimen: (Praziquantel 100 mg/kg per day PO tid for 1 day, then 50 mg/kg/day tid AND Dexamethasone 0.1mg/kg per day with or without anti-seizure medication) all for 29 days.
  • Note (1): Albendazole associated with 46% decrease in seizures.
  • Note (2): Praziquantel less cysticidal activity.
  • Note (3): Steroids decrease serum levels of Praziquantel
  • Note (4): NIH reports Methotrexate at ”20 mg/wk allows a reduction in steroid use.
  • 3. Degenerating cysts
  • 3.1 Patients body weight of ≥60 kg
  • Preferred regimen: Albendazole 400 mg PO bid AND Dexamethasone 0.1 mg/kg/day PO with or without anti-seizure medication all for 8-30 days
  • 3.2 Patients body weight of 60 kg
  • Preferred regimen: Albendazole 15 mg/kg/day PO bid (max. 800 mg/day) AND Dexamethasone 0.1 mg/kg/day PO with or without anti-seizure medication] all for 8-30 days
  • Alternative regimen: (Praziquantel 100 mg/kg per day PO tid for 1 day, then 50 mg/kg/day tid AND Dexamethasone 0.1mg/kg/day PO with or without anti-seizure medication) all for 29 days.
  • Note (1): Treatment improves prognosis of associated seizures.
  • Note (2): For dead calcified cysts, no treatment indicated
  • 4. Subarachnoid neurocysticercosis
  • 4.1 Patients body weight of ≥60 kg
  • Preferred regimen: Albendazole 400 mg PO bid AND Dexamethasone 0.1 mg/kg/day PO with or without anti-seizure medication all for 8-30 days
  • 4.2 Patients body weight of 60 kg
  • Preferred regimen: Albendazole 15 mg/kg/day PO bid (max. 800 mg/day) AND Dexamethasone 0.1 mg/kg/day PO with or without anti-seizure medication] all for 8-30 days
  • Alternative regimen: (Praziquantel 100 mg/kg per day PO tid for 1 day, then 50 mg/kg/day tid AND Dexamethasone 0.1mg/kg/day PO with or without anti-seizure medication) all for 29 days.
  • Note: Shunting for hydrocephalus, as without shunt, 50% of patients died within 9 years.
  • 5. Intraventricular neurocysticercosis
  • 5.1 Patients body weight of ≥60 kg
  • Preferred regimen: Albendazole 400 mg PO bid AND Dexamethasone 0.1 mg/kg/day PO with or without anti-seizure medication all for 8-30 days
  • 5.2 Patients body weight of 60 kg
  • Preferred regimen: Albendazole 15 mg/kg/day PO bid (max. 800 mg/day) AND Dexamethasone 0.1 mg/kg/day PO with or without anti-seizure medication] all for 8-30 days
  • Alternative regimen: (Praziquantel 100 mg/kg per day PO tid for 1 day, then 50 mg/kg/day tid AND Dexamethasone 0.1mg/kg/day PO with or without anti-seizure medication) all for 29 days
  • Note: Neuroendoscopic removal if obstruction of CSF circulation.

Sparganosis

  • Sparganosis (Spirometra mansonoides) treatment [2]
  • Preferred treatment: Surgical resection or ethanol injection of subcutaneous masses
Note: Source for Spirometra mansonoides larval cysts is frogs or snakes
  1. ↑ Gilbert, David (2014). The Sanford guide to antimicrobial therapy 2014. Sperryville, Va: Antimicrobial Therapy. ISBN 978-1930808782.
  2. ↑ Gilbert, David (2014). The Sanford guide to antimicrobial therapy 2014. Sperryville, Va: Antimicrobial Therapy. ISBN 978-1930808782.
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