One updated and conclusions changed Review, one updated Review (new search) and one new Protocol are available in Issue 1, 2010 of the Cochrane Database of Systematic Reviews:

Updated and conclusions changed review

 Katharine Abba, Sridharan Ramaratnam, Lakshmi Narasimhan Ranganathan, Anthelmintics for neurocysticercosis (Link to review)

Neurocysticercosis is an infection of the central nervous system that affects around 50 million people worldwide, causing at least 50,000 deaths each year, mostly in areas where people live in close contact with pigs and where sanitation is poor. It is caused by the accidental ingestion of eggs of a pork tapeworm; these eggs can lodge in different tissues of the body, including the brain, forming cysts. In endemic areas neurocysticercosis is the leading cause of adult-onset epilepsy and an important cause of seizures in children.

Treatment options for neurocysticercosis depend on the number, size, and location of the cysts, and on the patient’s symptoms. The two anthelmintics used are praziquantel and albendazole, often prescribed with corticosteroids to prevent inflammation of the brain. However, treatment with anthelmintics remains controversial because of potential adverse events and also because the parasite may in some cases die even without treatment.

This review assessed 21 small randomized controlled trials, almost all of albendazole, which is more used nowadays. This drug was found to reduce the number of viable lesions in adult patients, and to lower the number of seizures in children with non-viable lesions (i.e. cysts which are likely to resolve spontaneously). Also, corticosteroids may reduce the incidence of adverse events during treatment. The authors recommend more rigorous research and trials in people with different stages and numbers of lesions, and people with HIV.