Corticosteroid use in neurocysticercosis

Abstract

The cystic larvae of Taenia solium commonly infect the human nervous system, resulting in neurocysticercosis, a major contributor to seizure disorders in most of the world. Inflammation around the parasites is a hallmark of neurocysticercosis pathophysiology. Although mechanisms regulating this inflammation are poorly understood, anti-inflammatory drugs, particularly corticosteroids, have been long used alone or with anthelmintics to manage disease and limit neurological complications and perhaps damage to neural tissues. Only scarce controlled data exist to determine when and what type of corticosteroids and the treatment regime to use. This article revisits the mechanisms of action, rationale, evidence of benefit, safety and problems of corticosteroids in the context of neurocysticercosis, as well as alternative anti-inflammatory strategies to limit the damage caused by inflammation in the CNS.

Keywords::

• central nervous system
• corticosteroids
• cysticercosis
• neurocysticercosis
• seizures
• Taenia solium

Financial & competing interests disclosure

Funding for this study was in part provided by the US National Institute of Allergy and Infectious Diseases (NIAID), US NIH. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.