title: Drug therapy for solitary cysticercus granuloma: a systematic review and meta-analysis.
abstract: OBJECTIVE
  The effectiveness of anthelminthic and corticosteroid drug therapy in parenchymal neurocysticercosis is well established. The treatment of parenchymal solitary cysticercus granuloma (SCG), however, remains controversial. We attempted to obtain a consistent estimate of the efficacy of anthelminthic and corticosteroid drug treatment in SCG.
  
  
  METHODS
  Randomized-controlled trials (RCTs) comparing rates of seizure freedom, granuloma resolution, and residual calcification in individuals with SCG treated with anthelminthic or corticosteroid drugs with those treated with antiepileptic drugs (AEDs) alone were systematically reviewed and quantified using fixed- or random-effects meta-analysis.
  
  
  RESULTS
  Fifteen RCTs were identified for inclusion. Ten RCTs assigned 765 people with SCG to AED treatment with or without anthelminthic drug (albendazole) treatment. A further 5 RCTs assigned 457 people with SCG to AED treatment with or without corticosteroid drugs. Anthelminthic treatment was associated with significantly increased rates of seizure freedom (nonevent odds ratio: 2.45; 95% confidence interval: 1.49-4.03; p = 0.0004) and significantly higher rates of granuloma resolution (odds ratio: 2.09; 95% confidence interval: 1.41-3.00; p = 0.0003), but did not alter the risk of residual calcification. Corticosteroid treatment was not significantly associated with any outcome.
  
  
  CONCLUSIONS
  Anthelminthic treatment with albendazole provides improved rates of seizure freedom and hastens resolution of the granuloma. The role of corticosteroid treatment remains uncertain. The benefits (or lack thereof in the case of corticosteroids) are consistent when measured across different time points after treatment.
authors.affiliation: Department of Pediatric Neurology, Rudolf Magnus Institute of Neuroscience, University Medical Center Utrecht, The Netherlands. wim@invivonmr.uu.nl
authors.forename: Willem M
authors.initials: WM
authors.lastname: Otte
authors.forename: Monika
authors.initials: M
authors.lastname: Singla
authors.forename: Josemir W
authors.initials: JW
authors.lastname: Sander
authors.forename: Gagandeep
authors.initials: G
authors.lastname: Singh
mesh_terms: D000293:Adolescent; D015766:Albendazole / Q000627:therapeutic use; D000871:Anthelmintics / Q000627:therapeutic use*; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D002114:Calcinosis / Q000517:prevention & control; D002648:Child; D002675:Child, Preschool; D005260:Female; D006099:Granuloma / Q000188:drug therapy*; D006801:Humans; D007223:Infant; D008297:Male; D020019:Neurocysticercosis / Q000188:drug therapy*; D016017:Odds Ratio; D011223:Praziquantel / Q000627:therapeutic use; D011239:Prednisolone / Q000627:therapeutic use; D016032:Randomized Controlled Trials as Topic; D012640:Seizures / Q000453:epidemiology / Q000209:etiology; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000871:Anthelmintics; D000893:Anti-Inflammatory Agents; D011223:Praziquantel; D011239:Prednisolone; D015766:Albendazole