These results suggest that high-dose praziquantel therapy for cerebral sparganosis could achieve beneficial outcomes and that MRI plays an important part in follow-up, especially when medical symptoms have improved

These results suggest that high-dose praziquantel therapy for cerebral sparganosis could achieve beneficial outcomes and that MRI plays an important part in follow-up, especially when medical symptoms have improved. Introduction Sparganosis is a rare parasitic disease caused by an infection from the second-stage larvae of in serum was assessed by ELISA packages (# JL 0702193, Jianlun Biology Technology Co., LTD, Guangzhou, P.R. inoperable individuals and the tasks of MRI and peripheral eosinophil complete counts during follow-up. Strategy Baseline and follow-up epidemiological, medical, radiological and restorative data related to 10 inoperable individuals with cerebral sparganosis that were treated with repeated programs of high-dose praziquantel therapy, with each program consisting of 25 mg/kg thrice daily for 10 days were assessed, followed by analyses of the prognoses, MRI findings and peripheral eosinophil complete counts. Principal findings Baseline medical data: the medical symptoms recorded included seizures, hemiparesis, headache, vomiting and modified mental status. Peripheral blood eosinophilia was found in 3 individuals. The baseline radiological findings were as follows. Motile lesions were observed in 10 patients, including aggregated ring-like enhancements, tunnel signs, serpiginous and irregular enhancements. Nine of the 10 patients had varying degrees of white matter degeneration, cortical atrophy and ipsilateral ventricle dilation. The follow-up clinical data were as follows. Clinical symptom relief was found in 8 patients, symptoms were eliminated in 1 patient, and symptoms showed no change from baseline in 1 patient. Peripheral blood eosinophilia was found in 2 patients. The follow-up radiological findings were as follows. Motile lesions that were transformed into stable, chronic lesions were found in 8 patients, and motile lesions that were eliminated completely were found in 2 patients. Conclusions High-dose praziquantel therapy for cerebral sparganosis is effective. The radiological outcomes of motile lesions are an important indication during the treatment process, especially during follow-ups after clinical symptoms have improved. Peripheral eosinophil complete counts cannot be used as an effective prognostic indication. Author summary Sparganosis is usually a rare parasitic disease with a high prevalence in East Asia. Because of limited radiological technology and clinical experience, the prevalence of cerebral sparganosis is likely underestimated in developing countries. Cerebral sparganosis is the most severe complication of human sparganosis. Currently, it is generally believed that the most effective treatment for cerebral sparganosis is usually surgical treatment. However, the choice of treatment is usually a challenge for inoperable patients, including those with multifocal lesions or lesions in deep structures or important functional areas and those refusing invasive treatment due to personal willingness. SR 146131 Currently, there is no standard for the treatment of inoperable patients. In addition, anthelmintic treatment for sparganosis has rarely been reported in the literature. High-dose praziquantel therapy is usually a useful therapeutic choice for many cerebral parasitic diseases, including neurocysticercosis, and is well tolerated for patients, but it has not been sufficiently evaluated for the treatment of cerebral sparganosis. This study aims to describe the clinical, radiological and therapeutic data following high-dose praziquantel therapy for ten inoperable patients. All patients reached clinical cure after one to five courses. These results suggest that high-dose praziquantel therapy for cerebral sparganosis could accomplish favorable outcomes and that MRI plays an important role in follow-up, especially when clinical symptoms have improved. Introduction Sparganosis is usually a rare parasitic disease caused by an infection by the second-stage larvae of in serum was assessed by ELISA packages (# JL 0702193, Jianlun Biology Technology Co., LTD, Guangzhou, P.R. China). All patients underwent stool examinations. All patients were inoperable due to the following reasons. First, there were multifocal lesions and functional deficiencies. Second, the lesions SR 146131 were in areas where operation was contraindicated. Third, the patients refused invasive treatment. Treatment All patients were treated with high-dose praziquantel. The high-dose praziquantel treatment consisted of daily praziquantel at a dose of 75 mg per kilogram of body weight, which was administered in three divided doses, for 10 days. Dexamethasone was administered if symptoms exacerbated with praziquantel therapy. 5 mg was given initially followed by 10 mg/day until the end of the 10 day course and then tapered with 5 mg/ for 3 days and then 4.5 mg/day for 5 days. The patients who presented with symptomatic epilepsy were treated with oxcarbazepine. Daily oxcarbazepine at a dose of 10 mg per kilogram of body weight, which was administered in two divided doses, was used to treat parasite-induced symptomatic epilepsy. The anticonvulsive treatment was slowly tapered when the seizures discontinued[1, 17, 19, Rabbit polyclonal to IL20RB 20]. Praziquantel was administered in 10 day courses every 3 months until there was clinical improvement and serial MRI studies showed disappearance of the initial enhancing lesions or replaced by stable, chronic lesions. Repeated 10 day SR 146131 courses were also given if new symptoms recurred. At least 3 follow-up MRI assessments were performed.

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