Abstract Details

Title Treatment for Persistent Subarachnoidal and Spinal Neurocysticercosis

Topic Infections/AIDS/Prion Disease

Presentation(s) P04 - (-)

Poster/Presentation
Number 004

Objective

Background BACKGROUND: Despite optimal doses of treatment, subarachnoid NCC cysts may persist or new forms may arise. Treatment protocols for unrelenting NCC have not been clearly established.

Design/Methods DESIGN/METHODS: Multiple sequential MRI and MRI cisternography with intrathecal gadolinium, as well as laboratory studies were performed after prolonged courses of treatment (30 to 90 days) with albendazole at doses of 30mg/kg. A method for counting active lesions was designed giving one point for each cistern involved, for each spinal region, for each gigantic, intermediate or small cyst, and for the presence of hydrocephalus and arachnoiditis. At each visit we compared the total score with the previous results.

Results RESULTS: Four men with a mean age of 65 years showed new onset of symptoms and new cysts or growth of the previous cysts in 3 years of follow-up. Mean time between onset and the first relapse was 11.5 (2-31) months, 19.3 (6-33) months for the second and 22(9-35) months for the third. Recurrence symptoms were severe daily headache (75%), altered mental status (50%) and Bruns syndrome (25%). MRI scores decreased from 25 to only 22 points after the first course of treatment with albendazole 30mg/kg for one month, to 14.5 points with albendazole 30mg/kg for 1 month, and to 7.5 with albendazole 30mg/kg for 3 consecutive months. Secondary effects of the medication were loss of hair (100%) and transient increase in the liver function tests (50%).

Conclusions CONCLUSIONS: One cycle with high doses of albendazole for 15 days was not enough as patients began with symptoms after a period of clinical stability, subarachonoideal cysts persisted or expanded, and new ones appeared. Three consecutive months with high doses of albendazole showed better responses with tolerable side effects.

Authors/Disclosures
Maria Alejandra Gonzalez Duarte, MD, FAAN (NYU Dysautonomia Center) PRESENTER	Dr. Gonzalez Duarte has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Alnylam. Dr. Gonzalez Duarte has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Astra Zeneca. Dr. Gonzalez Duarte has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Alnylam . The institution of Dr. Gonzalez Duarte has received research support from Pfizer.
	No disclosure on file
	No disclosure on file
	No disclosure on file
John C. Brust, MD (New York Neurological Insitiute)	No disclosure on file
Juanzhi Fang (EMD Serono)	No disclosure on file

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