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Praziquantel in the Treatment of Cysticercosis-Reply

Frank Richards Jr, MD
JAMA. 1986;256(3):349-350. doi:10.1001/jama.1986.03380030051020.
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In Reply.—  We chose to forego a discussion of the medical management of human T solium cysticercosis, since we were principally concerned with the epidemiology of the disease in southern California. Although praziquantel clearly represents a very important step in the medical treatment of this condition, this drug should not be considered a panacea. Some authors experienced in treating cysticercosis remain cautious about when and how praziquantel should be used.1,2 Since some forms of the disease do not respond to praziquantel, all patients with cysticercosis are not candidates for therapy. The possibility of the cerebrospinal fluid reaction syndrome, which has been associated with death, makes it desirable to hospitalize patients being treated for one to two weeks, during which time fairly high doses of steroids are usually administered. In contrast, our study suggests that extended or multiple hospitalizations for this condition are rare— perhaps an indication that in many


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