title: Incidental consequences of antihelmintic treatment in the central nervous system.
abstract: BACKGROUND
  Neurocysticercosis (NCC) is the most common parasitic infection in the central nervous system and the most common cause of acquired neurological symptoms in young adults living in developing countries. Many "asymptomatic" patients begin experiencing neurological symptoms after the use of antiparasitic drugs for gastrointestinal treatment. Patients who are previously diagnosed with NCC require special care during cysticidal treatment because of the inflammatory effects caused by the interaction between the drug, the parasite, and the host.
  
  
  METHODS
  Of a series of 46 cases, we selected five patients with a history of being "asymptomatic" and who began experiencing neurologic symptoms after the use of albendazole, which led to a diagnosis of cysticercosis. Another case of the patient, who already had been diagnosed of ventricular cysticercosis, was given a drug treatment without consulting the neurosurgeon and had a fatal outcome attributable to secondary meningoencephalitis.
  
  
  RESULTS
  In the first five cases, with new neurological symptoms after antihelmintic treatment, the self-prescription is remarkable. The symptoms appear between the third and fifth day of treatment. All of them had a clinical course without complications. Only two cases minimally invasive techniques were required. The case who had been already diagnosed developed meningoencephalitis and died after eight days of antihelmintic treatment.
  
  
  CONCLUSIONS
  Anthelminthic drug treatment requires tailor-based prescription considering risk-benefit ratio with the drug-parasite-host interaction in mind. Treatment is not harmless so patients have to be closely watched. In select cases, medical treatment cannot replace surgical procedures, which can be the primary approach with drug treatment as a complement.
authors.affiliation: Neurosurgical Research Laboratory, Department of Neurosciences, Center of Health Sciences, University of Guadalajara, Guadalajara, Mexico. rodrigor@cencar.udg.mx
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Ramos-Zúñiga
authors.forename: H Raúl
authors.initials: HR
authors.lastname: Pérez-Gómez
authors.forename: Fernando
authors.initials: F
authors.lastname: Jáuregui-Huerta
authors.forename: María
authors.initials: M
authors.lastname: del Sol López-Hernández
authors.forename: Jazmín Elizabeth
authors.initials: JE
authors.lastname: Valera-Lizárraga
authors.forename: Gabriela
authors.initials: G
authors.lastname: Paz-Vélez
authors.forename: Adán
authors.initials: A
authors.lastname: Becerra-Valdivia
mesh_terms: D000293:Adolescent; D000328:Adult; D015766:Albendazole / Q000008:administration & dosage* / Q000009:adverse effects*; D000871:Anthelmintics / Q000008:administration & dosage / Q000009:adverse effects; D002490:Central Nervous System / Q000187:drug effects* / Q000276:immunology / Q000469:parasitology; D020808:Central Nervous System Protozoal Infections / Q000188:drug therapy / Q000276:immunology / Q000601:surgery; D016903:Drug Monitoring; D017809:Fatal Outcome; D005260:Female; D006790:Host-Parasite Interactions / Q000187:drug effects / Q000276:immunology; D006801:Humans; D008297:Male; D020019:Neurocysticercosis / Q000188:drug therapy* / Q000276:immunology / Q000601:surgery; D055815:Young Adult
chemical_list: D000871:Anthelmintics; D015766:Albendazole