Nii Y, Nakagawa H, Taki T, Nakabayashi T
Department of Neurosurgery, Center for Adult Disease, Osaka, Japan.
No Shinkei Geka. 1988 Aug;16(9):1083-8.
A case of a 56-year-old Korean man with cerebral cysticercosis was reported. This case demonstrated the first successful treatment with praziquantel in Japan and also the usefulness of a low-dose regime in the treatment of cerebral cysticercosis. The patient was admitted to our hospital with a 7 years history of generalized seizure and a 6 months history of gait disturbance. He had 6 subcutaneous nodules. A CT scan of the brain showed multiple cysts containing a small calcification and the largest lesion measured 5 cm in diameter in the cerebellar vermis. Posterior fossa craniectomy was performed and the cyst was pathologically confirmed as cysticercosis. A month postoperatively the patient was given praziquantel 50 mg/kg body weight in 3 divided doses per day. But medication with praziquantel was stopped on the 5th day because of severe headache, nausea and vomiting. He was readmitted 6 months later with appearance of gait disturbance, left facial paresis and dysphagia. A CT scan revealed enlargement of some of the residual cysts. The patient was then given smaller doses of praziquantel 8 mg/kg body weight in 3 divided doses with steroid cover for 48 days. He experienced no side effect during the therapy and became free from the neurological symptoms. A CT scan showed complete disappearance and only numerous small calcifications of the cysts.
报告了一例56岁韩国男性脑囊尾蚴病病例。该病例展示了在日本吡喹酮首次成功治疗脑囊尾蚴病，以及低剂量疗法在治疗脑囊尾蚴病中的有效性。患者因全身性癫痫发作7年和步态障碍6个月入住我院。他有6个皮下结节。脑部CT扫描显示多个含有小钙化的囊肿，最大病变位于小脑蚓部，直径5厘米。进行了后颅窝颅骨切除术，囊肿经病理证实为囊尾蚴病。术后1个月，患者每天给予吡喹酮50mg/kg体重，分3次服用。但由于严重头痛、恶心和呕吐，吡喹酮治疗在第5天停止。6个月后，他因步态障碍、左侧面部麻痹和吞咽困难再次入院。CT扫描显示一些残留囊肿增大。然后患者给予较小剂量的吡喹酮8mg/kg体重，分3次服用，并给予类固醇治疗48天。治疗期间他未出现副作用，神经症状消失。CT扫描显示囊肿完全消失，仅留下许多小钙化灶。
