1

Téma: Neurocysticercosis

Symptomy (su zavisle na tom kde a kolko cyst je v mozgu) -
najhlavnejsie (70-90% pacientov): zachvaty(epilepticke), bolenie hlavy,
menej vyrazne : zmatenost, nedostatok pozornosti(zaujmu) k ludom, problemy s rovnovahou, hydrocephalus (vodnatenie mozgu), rozpinanie mozgu
http://www.medterms.com/script/main/art … ekey=18496

Davkovanie:
15 mg/kg/day for 4 weeks
The optimal dose and duration of anti-parasitic therapy for subarachnoid cysticercosis has not been established. In the largest cases series, Proano and others10 treated 33 patients with giant cysticerci with ABZ (15 mg/kg/day for 4 weeks). There was only a single death (from aplastic anemia) at a median follow-up of 59 months. However, most patients required several courses of anti-parasitic therapy. Thus, a single course of albendazole for four weeks is likely inadequate. Similarly, the optimal dose and duration of anti-inflammatory therapy has not been well defined. One regimen that we have used begins with prednisone (60 mg/day for 10 days) and gradually tapering the dose by 5 mg/day every five days thereafter.
http://www.ajtmh.org/cgi/content/full/72/1/3

alebo:Adults and adolescents weighing 60 kg or more: Oral, 400 mg two times a day for eight to thirty days. (400mg 2xdenne od 8 do 30 dni)
http://www.drugs.com/mmx/zentel.html

Kontrolovať:
Pacienti se zvýšenými jaterními testy (zvýšené hodnoty transamináz) před zahájením terapie albendazolem by měli být v průběhu léčby pečlivě sledováni.

U lidí se albendazol po perorálním podání špatně vstřebává (<5 %).

Pokud je dávka podána společně s tučným jídlem, které zvyšuje absorpci albendazolu asi na pětinásobek, je farmakologický účinek albendazolu vyšší.

http://www.farmaceutika.info/zentel#spc


Krvne testy raz za 2 tyzdne:
For patients on long-term therapy
» Complete blood counts (CBCs) and
» Liver function tests    (since albendazole may cause a reduction in total white cell counts and an elevation in hepatic enzymes with prolonged use, it is recommended that blood counts and liver function tests be carried out prior to treatment and every 2 weeks during treatment with albendazole; re-treatment should not be initiated if significant depression in total white cell counts or elevation in liver enzymes persists
http://www.drugs.com/mmx/zentel.html

Príčina:
larvy pasomnice, hlisty z bravcoveho masa
http://www.drugs.com/mmx/zentel.html
Neurocysticercosis (treatment)1—Albendazole is used in the treatment of parenchymal neurocysticercosis caused by the larval form of Taenia solium (pork tapeworm). It is the only agent used in the treatment of ocular neurocysticercosis

Uspešnosť liečby:
http://jnnp.bmj.com/content/62/6/659.ab … f_ipsecsha
Pri tejto liecbe 17 pacientov mali 82% uspech - zmizli cysty  po 8-dnoch liecby abendazolom
15 mg/kg/day for eight days

Priznaky choroby a rizika antiparazitickej liečby (...akutne záchvaty, nárast vnutrolebečného tlaku, smrť 1-4%):
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1176337/

Neurocysticercosis typically is first seen either with seizures (70% to 90% of acutely symptomatic patients) or headache . Headache usually indicates the presence of hydrocephalus, meningitis, or increased intracranial pressure.

Some authors suggest that antiparasitic treatment might be counterproductive and expose patients to increased risk (12,27). The risks of antiparasitic therapy include gastrointestinal side effects, acute seizures, increased intracranial pressure, and rarely, death (1,12,16,26). Side effects, although usually mild, include nausea, headache, seizures, and occasionally, cerebral edema (26,27). Deaths associated with antiparasitic treatment are rare (1% to 4%) and occur primarily in patients with hydrocephalus, increased intracranial pressure, and heavy cyst burden

Doba, kedy sa prejaví choroba - mesiace až roky po infekcii, zvyčajne vtedy, keď cysty odumierajú. Vtedy múže začať opúchať mozog - bolesti hlavy. Cysty vo svaloch nesposobuju problemy.
http://www.cdc.gov/ncidod/dpd/parasites … rcosis.htm
How long will I be infected before symptoms begin?
Symptoms can occur months to years after infection, usually when the cysts are in the process of dying. When this happens, the brain can swell. The pressure caused by swelling is what causes most of the symptoms of neurocysticercosis. Most people with cysticerci in muscles won’t have symptoms of infection.
Je demencia pri neurocyst... nevratna ?
http://jnnp.bmj.com/content/76/8/1164.full

NAJVIAC ZO VŠETKÉHO MA ZAUJÍMA PRAVDA.

2

Re: Neurocysticercosis

(porovnanie účinnosti liečby  15 mg/Kg 7 dni a 15 mg/Kg 28 dni - vysledok je liečby je rovnaký)

Singhi 3, in a prospective, randomized, double blind study with 122 children with neurocysticercosis, treated half of the patients with albendazole (15 mg/Kg) for 7 days and the other group was treated with the same drug and the same dosage for 4 weeks. He came to the conclusion that the 1 week treatment was as effective as the treatment for 28 days. The exactly time of the terapy with albendazole still remains unclear 3. Other authors recommended the treatment with albendazole for 28 to 30 days and that can reach even 60 days of treatment 1,4,5.
http://www.scielo.br/scielo.php?pid=S00 … ci_arttext

NAJVIAC ZO VŠETKÉHO MA ZAUJÍMA PRAVDA.