Combination therapy with albendazole and praziquantel versus albendazole alone in children with seizures and single lesion neurocysticercosis: a randomized, placebo-controlled double blind trial.

BACKGROUND: A combination of albendazole and praziquantel was more effective than albendazole alone in destroying Taenia cysts in an animal model. There are no such studies in humans.

OBJECTIVE: To evaluate the efficacy and safety of a combination of albendazole and praziquantel in children with seizures and single small enhancing computerized tomographic lesions.

STUDY TYPE: Prospective, interventional, randomized, placebo-controlled, double blind clinical trial at a tertiary hospital in North India.

SUBJECTS: : One hundred twelve children with seizures for <3 months and single lesion neurocysticercosis; 9 lost to follow-up.

INTERVENTION: All children received albendazole (15 mg/kg/d) for 7 days with either praziquantel or placebo (75 mg/kg/d) for 1 day according to random allocation. Repeat CT scans were done after 1, 3, and 6 months. All children were followed up for at least 6 months.

RESULTS: Fifty-three children received praziquantel (group A) and 50 placebo (group B). Complete resolution of lesions was seen in 60% and 72% of children at 3 and 6 months in group A versus 42% and 52% of children in group B. Nonresolution and calcification were higher in group B than in group A at 3 months (B: 28%, 14%; A: 12%, 8%) and 6 months (B: 16%, 22%; A: 6%, 9%), but the differences were not statistically significant. Seizure control and side effects were similar in the 2 groups.

CONCLUSIONS: A combination therapy for albendazole and praziquantel was statistically comparable to sole therapy with albendazole in eradicating lesions and preventing seizures.