Sandbox mj
Neurocysticercosis
- Neurocysticercosis
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- Neurocysticercosis treatment (NCC)[1]
- 1. Larval form of Taenia solium
- Preferred regimen: Praziquantel 5-10 mg/kg PO for single dose for children & adults.
- 2. Parenchymal neurocysticercosis
- 2.1 Patients body weight of ≥60 kg
- Preferred regimen: Albendazole 400 mg PO bid AND Dexamethasone 0.1 mg/kg/day with or without anti-seizure medication all for 8-30 days
- 2.2 Patients body weight of 60 kg
- Preferred regimen: Albendazole 15 mg/kg/day PO bid (max. 800 mg/day) AND Dexamethasone 0.1 mg/kg/day with or without anti-seizure medication] all for 8-30 days
- Alternative regimen: (Praziquantel 100 mg/kg per day PO tid for 1 day, then 50 mg/kg/day tid AND Dexamethasone 0.1mg/kg per day with or without anti-seizure medication) all for 29 days.
- Note (1): Albendazole associated with 46% decrease in seizures.
- Note (2): Praziquantel less cysticidal activity.
- Note (3): Steroids decrease serum levels of Praziquantel
- Note (4): NIH reports Methotrexate at 20 mg/wk allows a reduction in steroid use.
- 3. Degenerating cysts
- 3.1 Patients body weight of ≥60 kg
- Preferred regimen: Albendazole 400 mg PO bid AND Dexamethasone 0.1 mg/kg/day with or without anti-seizure medication all for 8-30 days
- 3.2 Patients body weight of 60 kg
- Preferred regimen: Albendazole 15 mg/kg/day PO bid (max. 800 mg/day) AND Dexamethasone 0.1 mg/kg/day with or without anti-seizure medication] all for 8-30 days
- Alternative regimen: (Praziquantel 100 mg/kg per day PO tid for 1 day, then 50 mg/kg/day tid AND Dexamethasone 0.1mg/kg per day with or without anti-seizure medication) all for 29 days.
- Note (1): Treatment improves prognosis of associated seizures.
- Note (2): For dead calcified cysts, no treatment indicated
- 4. Subarachnoid neurocysticercosis
- 4.1 Patients body weight of ≥60 kg
- Preferred regimen: Albendazole 400 mg PO bid AND Dexamethasone 0.1 mg/kg/day with or without anti-seizure medication all for 8-30 days
- 4.2 Patients body weight of 60 kg
- Preferred regimen: Albendazole 15 mg/kg/day PO bid (max. 800 mg/day) AND Dexamethasone 0.1 mg/kg/day with or without anti-seizure medication] all for 8-30 days
- Alternative regimen: (Praziquantel 100 mg/kg per day PO tid for 1 day, then 50 mg/kg/day tid AND Dexamethasone 0.1mg/kg per day with or without anti-seizure medication) all for 29 days.
- Note: Shunting for hydrocephalus, as without shunt, 50% of patients died within 9 years.
- 5. Intraventricular neurocysticercosis
- 5.1 Patients body weight of ≥60 kg
- Preferred regimen: Albendazole 400 mg PO bid AND Dexamethasone 0.1 mg/kg/day with or without anti-seizure medication all for 8-30 days
- 5.2 Patients body weight of 60 kg
- Preferred regimen: Albendazole 15 mg/kg/day PO bid (max. 800 mg/day) AND Dexamethasone 0.1 mg/kg/day with or without anti-seizure medication] all for 8-30 days
- Alternative regimen: (Praziquantel 100 mg/kg per day PO tid for 1 day, then 50 mg/kg/day tid AND Dexamethasone 0.1mg/kg per day with or without anti-seizure medication) all for 29 days
- Note: Neuroendoscopic removal if obstruction of CSF circulation.
Sparganosis
- Sparganosis
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- Sparganosis (Spirometra mansonoides) treatment [2]
- Preferred treatment: Surgical resection or ethanol injection of subcutaneous masses
- Note: Source for Spirometra mansonoides larval cysts is frogs or snakes
- ↑ Gilbert, David (2014). The Sanford guide to antimicrobial therapy 2014. Sperryville, Va: Antimicrobial Therapy. ISBN 978-1930808782.
- ↑ Gilbert, David (2014). The Sanford guide to antimicrobial therapy 2014. Sperryville, Va: Antimicrobial Therapy. ISBN 978-1930808782.