• Matthew L Romo, Katarzyna Wyka, Arturo Carpio, Denise Leslie, Howard Andrews, Emilia Bagiella, W Allen Hauser, Elizabeth A Kelvin, and Ecuadorian Neurocysticercosis Group.
• Epidemiology & Biostatistics Program, School of Urban Public Health at Hunter College, City University of New York, 2180 Third Avenue, New York, New York 10035, USA CUNY School of Public Health, 2180 Third Avenue, New York, New York 10035, USA.
• Trans. R. Soc. Trop. Med. Hyg. 2015 Nov 1; 109 (11): 738-46.

BackgroundRandomized controlled trials have found an inconsistent effect of anthelmintic treatment on long-term seizure outcomes in neurocysticercosis. The objective of this study was to further explore the effect of albendazole treatment on long-term seizure outcomes and to determine if there is evidence for a differential effect by seizure type.MethodsIn this trial, 178 patients with active or transitional neurocysticercosis cysts and new-onset symptoms were randomized to 8 days of treatment with albendazole (n=88) or placebo (n=90), both with prednisone, and followed for 24 months. We used negative binomial regression and logistic regression models to determine the effect of albendazole on the number of seizures and probability of recurrent or new-onset seizures, respectively, over follow-up.ResultsTreatment with albendazole was associated with a reduction in the number of seizures during 24 months of follow-up, but this was only significant for generalized seizures during months 1-12 (unadjusted rate ratio [RR] 0.19; 95% CI: 0.04-0.91) and months 1-24 (unadjusted RR 0.06; 95% CI: 0.01-0.57). We did not detect a significant effect of albendazole on reducing the number of focal seizures or on the probability of having a seizure, regardless of seizure type or time period.ConclusionsAlbendazole treatment may be associated with some symptomatic improvement; however, this association seems to be specific to generalized seizures. Future research is needed to identify strategies to better reduce long-term seizure burden in patients with neurocysticercosis.© The Author 2015. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

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