Severe forms of neurocysticercosis: treatment with albendazole

Study of 22 patients with the severe form of neurocysticercosis treated with albendazole (ABZ) administered in 6 different schedules ranging from 15 to 30 mg/kg/day for 21 to 60 days. Dextrochloropheniramine and ketoprofen were the adjuvant drugs. Multiple symptoms were observed in 90.9% of patients. Intracranial hypertension was manifested in 90.9%. Hydrocephaly occurred in 86.4%. Evolution was satisfactory in 10 patients, 8 died and 4 had sequelae. Tomographic studies showed the appearance of an isolated IVth ventricle in 9 patients, after ventriculoperitoneal shunt, before ABZ treatment in 3 of them, during in 5 and after treatment in one. Median clinical follow-up duration was 10 months for the patients who died and 3-4 years for survivors. In 3 patients there was an increase in cyst size during the administration of the 15 mg/kg/day ABZ dose, which was not observed in any patient when the 30 mg/kg/day dose was used.Estudo de 22 doentes, com a forma grave de neurocisticercose, tratados com albendazol (ABZ), administrado em 6 diferentes esquemas, que variaram de 15 a 30 mg/kg/dia, durante 21 a 60 dias. A dextroclorofeniramina e o cetoprofeno foram as drogas coadjuvantes. Múltiplos sintomas ocorreram em 20 doentes. Hipertensão intracraniana foi manifestação mais comum em 20. Hidrocefalia foi detectada em 19. A evolução foi satisfatória em 45,4%, faleceram 36,4% e 18,2% ficaram com sequelas. Na evolução tomográfica apareceu IVº ventrículo isolado em 40,9%, após derivação ventriculoperitoneal, em 3 deles antes do tratamento com ABZ, em 5 durante e, em um, após o tratamento. A mediana estatística do período de seguimento clínico foi 10 meses para aqueles que faleceram e 3-4 anos para os sobreviventes. Em 3 doentes houve aumento no tamanho dos cistos durante a dose de 15 mg/kg/dia de ABZ, não observado na vigência de 30 mg/kg/dia

Rabdomiolise e mioglobinuria: relato de caso agudo com boa evolução

Os autores registram um caso de mioglobinúria confirmada pela eletroforese de proteínas da urina. A eletromiografia revelou alterações de tipo polimiosítico. A biópsia muscular do deltóide esquerdo mostrou processo inflamatório muscular inespecífico. O tratamento instituído baseou-se em repouso, hiperhidratação e alcalinização da urina. Os autores enfatizam a importância do diagnóstico pela relativa benignidade do processo, que tende para a cura se forem superadas as sérias complicações da fase aguda, a iatrogenia medicamentosa e por procedimentos diagnósticos desnecessários no início da doença

Development of an experimental model of neurocysticercosis-induced hydrocephalus. Pilot study

ABSTRACT PURPOSE: To develop an experimental model of neurocysticercosis-induced hydrocephalus METHODS: There were used 17 rats. Ten animals were inoculated with Taenia crassiceps cysts into the subarachnoid. Five animals were injected with 0.1ml of 25% kaolin (a standard solution for the development of experimental hydrocephalus) and two animals were injected with saline. Magnetic resonance imaging (MRI) was used to evaluate enlargement of the ventricles after one or three months of inoculation. Volumetric study was used to quantify the ventricle enlargement. RESULTS: Seven of the 10 animals in the cyst group developed hydrocephalus, two of them within one month and five within three months after inoculation. Three of the five animals in the kaolin group had hydrocephalus and none in the saline group. Ventricle volumes were significantly higher in the 3-months MRI cyst subgroup than in the 1-month cyst subgroup. Differences between cyst subgroups and kaolin group did not reach statistical significance. CONCLUSION: The developed model may reproduce the human condition of neurocysticercosis-related hydrocephalus, which exhibits a slowly progressive chronic course

Analysis of cerebrospinal fluid in racemose form of neurocysticercosis

The present work aimed to evaluate the pattern of CSF alterations in patients diagnosed with neurocysticercosis (NCC) in racemose form.Method This is a retrospective cohort study of patients with diagnosis of NCC in racemose form. CSF samples from 26 patients were analyzed. After patient-chart analysis was performed descriptive analysis of case studies and comparison between sexes in relation to variables were obtained with CSF by Mann-Whitney and Student’s t-tests.Results The sexes did not differ statistically when compared to pleocytosis in CSF. Eosinophils were present in 31% in samples while the ELISA test presented 80% sensitivity in this case series. Of the patient total, 24 presented a meningitis pattern with lymphocytic predominance.Conclusion There was no difference in inflammatory pattern between the sexes, with predominance of lymphocytic meningitis and 80% sensitivity by ELISA test of CSF patients with racemose form of NCC.</sec