Early detection and management of neurological serious adverse events in relation to the administration of anthelminthic medicines to people with asymptomatic neurocysticercosis

Overview

Preventive anthelminthic chemotherapy programmes involving the administration of praziquantel or albendazole are used to control various neglected parasitic diseases in endemic communities. To control taeniasis, the administration of a single dose of praziquantel or albendazole for 3 consecutive days to persons with neurocysticercosis is not without risk, although the reported incidence of serious adverse events seems to be low. In persons with neurocysticercosis, it is known that the time between infection and symptoms can be as long as 20 years; thus, administration of anthelminthics could occur in individuals who have viable cysticerci in the brain but no symptoms.

Although preventive chemotherapy with praziquantel (or 3 consecutive doses of albendazole) is contraindicated in individuals with prior neurological signs/symptoms, this will not prevent the occurrence of serious adverse events, as these can occur in a healthy individual after anthelminthic intake. Such events are uncommon, but their severity requires that all personnel involved in preventive chemotherapy be aware of them.