Steroids and Neurocysticercosis

Q: Why steroids remain the mainstays in the treatment against Neurocysticercosis?

Answer: Albendazole and Praziquantel are both effective in the treatment of Neurocysticercosis, but they are given under the cover of steroids. 

Cytosol of dying parasites creates an immense inflammatory reaction, which can itself be fatal, causing mental status change and convulsions. Steroids attenuate this inflammatory response.

Also, when co-administered with a steroid, Albendazole results in increased absorption.

Note: Both Albendazole and Praziquantel are recommended to be given with fatty meals.

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References:

1. White AC. Controlling the Host Response in Neurocysticercosis. Am J Trop Med Hyg. 2019 Mar;100(3):483-484. doi: 10.4269/ajtmh.18-0908. PMID: 30608054; PMCID: PMC6402923.

2. Hamamoto Filho PT, Fragoso G, Sciutto E, Fleury A. Inflammation in neurocysticercosis: clinical relevance and impact on treatment decisions. Expert Rev Anti Infect Ther. 2021 Dec;19(12):1503-1518. doi: 10.1080/14787210.2021.1912592. Epub 2021 Apr 9. PMID: 33794119.