Pediatric Neurocysticercosis Follow-up

Updated: Dec 15, 2020
  • Author: Vinod K Dhawan, MD, FACP, FRCPC, FIDSA; Chief Editor: Russell W Steele, MD  more...
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Follow-up

Further Outpatient Care

Children who have single nonviable lesions and do not require antihelminthic treatment can be managed safely on an outpatient basis. Most children can be managed as outpatients, especially in the United States where cases are often simple neurocysticercosis.

Arrange neurologic follow-up care to manage seizures and any sequelae.

Perform a follow-up MRI in 3-6 months or sooner if symptoms worsen or recur.

If a child who was admitted for antihelminthic treatment is doing well after 72 hours and follow-up care is assured, the child can be discharged to finish therapy at home.

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Further Inpatient Care

Indications for admission in patients with neurocysticercosis include the following:

  • Children who need antihelminthic therapy for active or multiple cysts (hospitalize for first 72 h of therapy)

  • Signs of increased intracranial pressure or apparent need for corticosteroid treatment

  • Recalcitrant seizures

  • Hydrocephalus, possibly requiring an intraventricular shunt

Arrange transfer if the facility is unable to provide neurologic or neurosurgical care deemed necessary.

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Inpatient & Outpatient Medications

Anticonvulsants

Carbamazepine and phenytoin are the first-choice treatments.

Antihelminthics

Antihelminthic medication is controversial. Reserve such treatment for certain cases. When antihelminthics are used, albendazole is preferable to praziquantel.

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Deterrence/Prevention

Prevention of exposure to infected ova in the home and community is the most effective preventative measure.

Examine stools from contacts using 3 consecutive daily specimens. If positive, contacts should receive single doses of praziquantel (10 mg/kg) or albendazole (400 mg).

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