[Ivermectin as a therapeutic alternative in neurocysticercosis that is resistant to conventional pharmacological treatment].
BACKGROUND
Neurocysticercosis is a public health problem that can be found in many parts of the world, especially in developing countries, and today's high rates of immigration are making it increasingly more common in developed countries. Cysticidal treatment of neurocysticercosis is a controversial issue because it is only partially effective against vesicular and colloidal-shaped cysts when the parasite persists after a course of albendazole or praziquantel, the only two therapeutic options that are currently available. Ivermectin is a very effective, safe veterinary and human antiparasitic drug, with occasional very mild side effects. It has been used for over 25 years in cases of endoparasitosis that do not respond well to treatment, such as filariasis, oncocerciasis, strongyloidiasis, etc. and also in ectoparasitoses, such as pediculolsis capitis and myasis. It acts in the myoneural junction on the receptors in the chloride channel by increasing their permeability and causing paralysis in adult worms or by a mediated immune mechanism when it acts on immature forms.


METHODS
We report the cases of four patients who were previously treated with albendazole reiteratively with radiological evidence, which shows the persistence of viable vesicular or colloidal-shaped cysts. These patients were given 10 mg/day of ivermectin for 15 consecutive days or 10 mg/day as an average for 30 days, with excellent clinical and radiological progress.


CONCLUSIONS
Ivermectin was effective and did not give rise to any side effects when used to treat these four patients, who were resistant to conventional treatment with albendazole and/or praziquantel.
Diazgranados-Sánchez
J A
JA
Centro Médico Imbanaco, Cali, Colombia.
Barrios-Arrázola
G
G
Costa
J L
JL
Burbano-Pabon
J
J
Pinzón-Bedoya
J
J
D000328:Adult; D000368:Aged; D000977:Antiparasitic Agents / Q000627:therapeutic use*; D004351:Drug Resistance; D005260:Female; D006801:Humans; D007559:Ivermectin / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D020019:Neurocysticercosis / Q000188:drug therapy*
D000977:Antiparasitic Agents; D007559:Ivermectin