The effect of albendazole treatment on non-seizure outcomes in patients with symptomatic neurocysticercosis

Trans R Soc Trop Med Hyg. 2018 Feb 1;112(2):73-80. doi: 10.1093/trstmh/try023.

Abstract

Background: There is little information about the impact of anthelminthic treatment on clinical symptoms other than seizures in neurocysticercosis (NC). We investigated the effect of albendazole on non-seizure symptoms experienced by patients with NC.

Methods: Data are from a randomized controlled trial comparing albendazole plus prednisone with placebo plus prednisone for treatment of NC among 173 patients with active or transitional NC cysts and new-onset symptoms. We performed negative binomial regression to examine the number of follow-up visits when a symptom was reported, logistic regression to examine the probability of experiencing the symptom and Cox proportional hazards models to examine the time to first reporting the symptom.

Results: Eighty-five percent of patients reported at least one non-seizure symptom at baseline. Those treated with albendazole had significantly lower odds of memory loss and/or confusion during months 1-24 (odds ratio [OR] 0.42, p=0.037) and significantly increased odds of anxiety and/or depression during months 1-12 (OR 1.87, p=0.049). No treatment difference existed in experiencing symptoms in general or in experiencing headaches, limb weakness or gait disturbances, vomiting, nausea and/or stomach pain or visual disturbances over the follow-up period.

Conclusions: While the prevalence of non-seizure symptoms was high, albendazole treatment was associated with only two significant differences in the non-seizure symptoms over follow-up. Further research is needed to identify strategies to reduce the long-term symptom burden in patients with NC.

Publication types

  • Comparative Study
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Administration, Oral
  • Albendazole / administration & dosage*
  • Animals
  • Anthelmintics / administration & dosage*
  • Double-Blind Method
  • Drug Administration Schedule
  • Drug Therapy, Combination
  • Female
  • Gait Disorders, Neurologic / drug therapy
  • Gait Disorders, Neurologic / parasitology
  • Gastrointestinal Diseases / drug therapy
  • Gastrointestinal Diseases / parasitology
  • Headache Disorders / drug therapy
  • Headache Disorders / parasitology
  • Humans
  • Male
  • Muscle Weakness / drug therapy
  • Muscle Weakness / parasitology
  • Neurocysticercosis / drug therapy*
  • Prednisone / administration & dosage
  • Taenia solium
  • Treatment Outcome

Substances

  • Anthelmintics
  • Albendazole
  • Prednisone