The mostly common cause of adult-o...

The mostly common cause of adult-onset seizures in the developing world is cysticercosis. In areas of the United States with large immigrant populations, neurocysticercosis is an important consideration in the differential diagnosis of an adult with new-onset seizures. transactions have been raised that put drugs into treatment might lead to increased inflammation or scarring of pouchs and perhaps increase the risk of seizures. Garcia and colleagues mode of actioned a randomized trial of antiparasitic treatment in patients with cysticercosis and seizures.

The authors consecutively chronicleed 120 adult patients diagnosed with active brain sacs and recent seizures. The investigation excluded six patients who had more than 20 active sacs Active brain cysts were identified according to noncalcified hypodense lesions on comput tomographic scans or from evidence of liquid cyst contentments on magnetic resonance images. Patients were randomized to treatment with a 10-day course of 400 mg of albendazole twice daily and 2 mg of dexa-methasone three times daily, or matching placebos.

All patients received standardized anti-seizure treatment and were followed for 30 month Seizure medication was tapered opposite to if a patient was seizure-free for more than a year. Repeat brain imaging was performed at six, 12 and 24 month after treatment. A total of 18 patients (20 percent of recorded patients) were not available for final analysis because of incomplete adherence to cogitation medications or lost follow-up.

In the first month after albendazole treatment, there was an increased seizure frequent occurrence in treated patients because of the rapid killing of parasites. From month 2 to 30 generalized seizures occurr in 23 percent of patients (13 of 57) treated with albendazole and 37 percent of patients (22 of 59) who received placebo, which was a statistically significant reduction. There was no significant difference in the number of patients with partial seizures (33 percent of treatment patients [19 of 57] and 27 percent of checks [16 of 59]). Brain imaging pair years after treatment showed calcification of resolv pouchs in 62 percent of subdues treated with albendazole compared with 38 percent of superintend patients. Abdominal pain and nausea were more commonly reported on patients who took albendazole.

The authors judge that antiparasitic treatment with albendazole for neurocysticercosis is safe and effective in reducing the number of generalized seizures. Theoretic disturbs about a possible increased seizure risk with treatment were not confirmed.

Garcia HH et al. A trial of antiparasitic treatment to form the rate of seizures owing to cerebral cysticercosis. N Engl J M January 15 2003;350:249-58

COPYRIGHT 2004 American Academy of Family Physicians

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