The Guideline Development Subcommittee of the AAN conducted a literature search and review of 10 Class I or Class II trials of treatment for parenchymal neurocysticercosis. Albendazole therapy, with or without corticosteroids, is probably effective in decreasing both long-term seizure frequency and the number of cysts demonstrable radiologically in adults and children with neurocysticercosis, and is well-tolerated. Insufficient information is available to assess efficacy of praziquantel. Albendazole plus either dexamethasone or prednisolone should be considered, both to decrease the number of active lesions on brain imaging studies (Level B) and to reduce long-term seizure frequency (Level B). The evidence is insufficient to support or refute the use of steroid treatment alone in patients with intraparenchymal neurocysticercosis (Level U). [1]

COMMENT. Cysticercal cysts evolve through 4 stages: vesicular with living larva, colloidal stage with degenerate larva, granulonodular stage with thickened cyst membrane, and calcification stage. Only cysts in the vesicular and colloidal stages contain the larvae and are amenable to anticysticercal treatment. Cysticercosis, infection with the larval form of Taenia solium, is the most common preventable cause of epilepsy in the developing world. [2]