IVERMECTIN AS AN ALTERNATIVE THERAPY IN SEVERE NEUROCYSTICERCOSIS CASES ,A STUDY

Dr (Col) Om Prakash Singh, Dr J. P. Singh, Dr Pushpkant Tiwari

Abstract


INTRODUCTION: This study was carried out at Military hospital Jabalpur, Madhya Pradesh, Varanasi to evaluate the
use of ivermectin in sever cases of neurocysticercosis patients from Jul 2011 To Jul 206.
MATERIALS AND METHODS: Patients included in this study were all confirmed cases of neurocysticercosis. Diagnosis was made by taking
detailed history, Clinical examination, Computed tomography (CT) and or Magnetic Resonance Imaging scan & serology wherever indicated.
Patients with active, transitional cysts and seizure were treated with steroids, albendazole and anticonvulsants. Seven children were given
multiple courses of albendazole. Ivermectin was used in five children after three courses (28 days) of albendazole in each of them.
RESULTS: There were a total of 26 confirmed patients of neurocysticercosis who completed this study. Mean age of the presentation was 9.6 ±
4.9 years, 58% of the patients were female. The clinical profile of patients was as follows - partial seizures 63.3%, generalized seizures- 37.7%,
headache - 67%, vomiting in 19 %, focal neurological deficit in 11% and combination of symptoms in 70% cases. Contrast CT brain showed a
solitary lesion in 18 (71.1%) and multiple lesions in the rest. CT/MRI lesions were transitional in 64%, inactive in 21% and mixed in 36%, All the
children were seizure free after two years of treatment and follow up). Ivermectin was used in five of the cases who did not respond to multiple
courses of albendazole. All the cases received anticonvulsants phenytoin, carbamezapine and midazolam if required, steroids, & albendazole.
Tab Ivermectin was used in seven of the cases with very good results.
CONCLUSION: Albendazole is effective in single as well as multiple ring enhancing lesions of neurocysticercosis in most of the cases, but in
severe and new reappearing cases, Ivermectin is very promising and without any side effects


Keywords


cysticercus, seizures, ring enhancing lesion, parenchymal lesion, albendazole, Ivermectin

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References


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