Incidence and significance of adverse effects of albendazole therapy in patients with a persistent solitary cysticercus granuloma

Objective - To study the incidence of adverse reactions to albendazole therapy in patients presenting with seizures and a persistent (>3 months after diagnosis), solitary cysticercus granuloma and to determine whether the occurrence of adverse reactions predicted the response of the granuloma to therapy. Material and methods - In a prospective study, adverse reactions were monitored in 43 patients with a persistent solitary cysticercus granuloma who were treated with albendazole therapy. Steroids were administered prophylactically to 7 patients. Response to albendazole therapy was determined on a post therapy CT scan done within 12 weeks of initiation of therapy. Results - Adverse reactions in the form of headache, vomiting or recurrence of seizures including focal status epilepticus occurred in 15 (34.9%) patients. Adverse reactions occurred in 3 of the 7 patients who received steroids during therapy. The occurrence of side effects was not significantly influenced by steroid therapy ( P =047). The granuloma responded to therapy in 20 patients (46.5%). Although the granuloma responded to therapy in a larger percentage of patients with side effects than in those without side effects (60% versus 39.3%), this difference was not statistically significant ( P =0.16). Conclusions - Albendazole therapy causes adverse reactions in about a third of patients with a persistent solitary cysticercus granuloma. Occurrence of adverse reactions cannot be prevented with steroid therapy and their occurrence does not predict the response of the granuloma to therapy.