Incidence and significance of adverse effects of albendazole therapy in patients with a persistent solitary cysticercus granuloma.

OBJECTIVE

To study the incidence of adverse reactions to albendazole therapy in patients presenting with seizures and a persistent (>3 months after diagnosis), solitary cysticercus granuloma and to determine whether the occurrence of adverse reactions predicted the response of the granuloma to therapy.

METHODS

In a prospective study, adverse reactions were monitored in 43 patients with a persistent solitary cysticercus granuloma who were treated with albendazole therapy. Steroids were administered prophylactically to 7 patients. Response to albendazole therapy was determined on a post therapy CT scan done within 12 weeks of initiation of therapy.

RESULTS

Adverse reactions in the form of headache, vomiting or recurrence of seizures including focal status epilepticus occurred in 15 (34.9%) patients. Adverse reactions occurred in 3 of the 7 patients who received steroids during therapy. The occurrence of side effects was not significantly influenced by steroid therapy (P=0.47). The granuloma responded to therapy in 20 patients (46.5%). Although the granuloma responded to therapy in a larger percentage of patients with side effects than in those without side effects (60% versus 39.3%), this difference was not statistically significant (P=0.16).

CONCLUSIONS

Albendazole therapy causes adverse reactions in about a third of patients with a persistent solitary cysticercus granuloma. Occurrence of adverse reactions cannot be prevented with steroid therapy and their occurrence does not predict the response of the granuloma to therapy.