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April 1983

Praziquantel Therapy for Cysticercosis-Reply

Author Affiliations

Department of Neurosciences University of California, San Diego San Diego, CA 92103

Arch Neurol. 1983;40(4):257-258. doi:10.1001/archneur.1983.04050040087023

In Reply.  —Several medical therapies for CNS cysticercosis are under investigation, including praziquantel,1,2 metrifonate,3 and radioactive antibodies.4 Although these uncontrolled studies show encouraging improvement, there are theoretical reasons for questioning their ultimate value. At least among patients in the United States, most symptoms result from chronic effects of the cysts at a time when further growth, reinfection, or even viability of the larvae is doubtful. Once the initial lesions are made, killing the worms may be irrelevant, and the only clinical goal worth attaining then becomes the reduction of local inflammation and edema of parenchyma, vessels, or meninges. At least initially, killing the organisms can actually increase the inflammatory response.2 Long-term benefits remain undocumented.Even though many morbidities and deaths still result from CNS cysticercosis, we now recognize that a benign or self-limited course is quite common (Archives 1982;39:534-539, 540-544). In a disease with such a variable prognosis

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