Department of Neurology, Upendra Devkota Memorial National Institute of Neurological and Allied Sciences, Bansbari, Kathmandu, Nepal.
Kathmandu Univ Med J (KUMJ). 2022 Jan-Mar;20(77):61-65.
Background Cerebral neurocysticerosis is a common parasitic disease of human nervous system but evidence on duration of albendazole therapy and their outcomes in this condition is inadequate Objective To evaluate the impact of varying duration of albendazole therapy on the clinical and radiological outcomes at one month in patients with active solitary neurocysticercosis. Method This is an interventional study conducted at Upendra Devkota Memorial National Institute of Neurological and Allied sciences, Bansbari over 1 year (2017 March - 2018 February). One hundred eighteen patients with new onset seizure secondary to active solitary cysticercal granuloma either received albendazole therapy for 1, 3, 9 or 21 days with the usual care or only received the usual care. Clinical and radiological outcomes were observed at one month follow-up. The difference in the proportion of the outcome measures between intervention and control groups were assessed using chi-square test. Result Our study included 118 patients with male predominance of 61.9%. Albendazole therapy for 3, 9 and 21 days reduced headache by 57.2%, 70.0% and 63.1% respectively which was higher than those with 1-day therapy or without the therapy. This difference in the proportion was statistically significant at p=0.001. Though seizure recurrence also declined but the difference was not significant (p=0.406) between groups. However, at one-month follow-up, majority of patients who received albendazole for 9 days (14, 70%) and 21 days (14, 73.7%) had normal lesion, while most calcified lesion (21, 67.7%) was observed in those who did not receive albendazole therapy. The difference between lesion among the groups was significant (p < 0.001). Conclusion Albendazole therapy in patients with active solitary neurocysticercosis for 9 days is as effective as 21 days and better than 3 days in headache control and lesion dissolution but seizure control could be achieved irrespective of the treatment.
脑囊虫病是一种常见的人类神经系统寄生虫病，但关于阿苯达唑治疗时间及其在该疾病中的疗效的证据不足。目的：评估不同时间长度的阿苯达唑治疗对活动性单发神经囊虫病患者一个月时临床和影像学结局的影响。方法：这是一项在 Upendra Devkota Memorial 国家神经病学和相关科学研究所（Bansbari）进行的干预性研究，时间为 1 年（2017 年 3 月至 2018 年 2 月）。118 例新发癫痫继发于活动性孤立性囊虫肉芽肿的患者，接受阿苯达唑治疗 1、3、9 或 21 天，同时给予常规护理，或仅给予常规护理。在一个月的随访时观察临床和影像学结局。采用卡方检验评估干预组和对照组之间结局指标比例的差异。结果：本研究共纳入 118 例男性为主（61.9%）的患者。阿苯达唑治疗 3、9 和 21 天分别使头痛缓解 57.2%、70.0%和 63.1%，高于 1 天治疗或未治疗的患者。这种比例的差异在 p=0.001 时具有统计学意义。虽然癫痫复发也有所下降，但组间差异无统计学意义（p=0.406）。然而，在一个月的随访时，接受阿苯达唑治疗 9 天（14 例，70%）和 21 天（14 例，73.7%）的患者中，多数病灶正常，而未接受阿苯达唑治疗的患者中则观察到多数钙化病灶（21 例，67.7%）。各组之间的病变差异具有统计学意义（p<0.001）。结论：在活动性单发神经囊虫病患者中，阿苯达唑治疗 9 天与 21 天同样有效，在缓解头痛和溶解病灶方面优于 3 天，但无论治疗与否，都能控制癫痫发作。
