Sunday, February 12, 2012

Incidental Consequences of Antihelmintic Treatment in the Central Nervous System

Publication year: 2012
Source: World Neurosurgery, Available online 10 February 2012
Rodrigo Ramos-Zúñiga, H. Raúl Pérez-Gómez, Fernando Jáuregui-Huerta, María del Sol López-Hernández, Jazmín Elizabeth Valera-Lizárraga, ...
BackgroundNeurocysticercosis (NCC) is the most common parasitic infection in the CNS, and the most common cause of acquired neurological symptoms in young adults living in developing countries. Many "asymptomatic" patients start having neurological symptoms after the use of antiparasitic drugs for gastrointestinal (GI) treatment. Patients who are previously diagnosed with NCC require special care during cysticidal treatment, due to inflammatory effects from the interaction between the drug, the parasite and the host.Case DescriptionOut of a series of 46 cases, we selected 5 patients with a history of being "asymptomatic" and who started having neurologic symptoms after the use of albendazole, which led to a diagnosis of cysticercosis. Another case of the patient, who already had been diagnosed of ventricular cysticercosis, was given drug treatment without consulting the neurosurgeon and had a fatal outcome due to secondary meningoencephalitis.ResultsIn the first 5 cases, with new neurological symptoms after antihelmintic treatment, the self-prescription is remarkable. The symptoms appear between the third and fifth day of treatment. All of them had a clinical course without complications. Only two cases minimally invasive techniques were required. The case that had been already diagnosed, developed meningoencephalitis and died after 8 days of antihelmintic treatment.ConclusionsAnthelminthic drug treatment requires tailor-based prescription considering risk-benefit ratio with the drug-parasite-host interaction in mind. Treatment is not harmless so patients have to be closely watched. In select cases, medical treatment cannot replace surgical procedures, which can be the primary approach with drug treatment as a complement.





No comments:

Post a Comment