RESUMO
Neurocysticercosis (NCC) is the most common parasitic disease of the central nervous system. Several drugs, such as drugs against tapeworms, praziquantel or albendazole associated to corticosteroids, have been tested for the treatment of this condition. Although some have claimed the reduction or involution of cystic or granulomatous lesions, there is no consensus about the efficacy of these treatments. The natural evolution of the disease is not clear and this hampers the assessment of treatment effects. Moreover, there are no good imaging or clinical indicators that can predict the progression or spontaneous resolution of lesions, specially at the meningeal or ventricular compartment. Therefore, evidence based medicine does not have a definitive answer about the treatment, neither of seizures, the most common manifestation of NCC, or the varied and complex meningeal and ventricular involvement. This review includes experts opinions to give the clinician some clues for decision making in the treatment of NCC.
Assuntos
Albendazol/uso terapêutico , Anti-Helmínticos/uso terapêutico , Neurocisticercose/tratamento farmacológico , Praziquantel/uso terapêutico , Animais , Vacinas Bacterianas/uso terapêutico , Medicina Baseada em Evidências , Humanos , Neurocisticercose/prevenção & controle , Taenia/efeitos dos fármacos , Taenia/crescimento & desenvolvimento , Taenia/imunologia , Resultado do TratamentoRESUMO
Despite the important achievements in clinical and experimental aspects of demylinating diseases and multiple sclerosis (MS), its pathogenesis still remains unknown. The most commonly held view is that it is an autoimmune disease, related in some way to a viral infection, that occurs in genetically susceptible hosts. Based on this, many current treatments for MS are designed to modulate the immune response and the interferons are an example. Only beta interferon has a dose dependent efficacy in phase III clinical trials, as treatment for remitting-relapsing forms. It produces a reduction in exacerbation rates and in the burden of the disease, measured by Magnetic Resonance imaging. The clinical use of beta interferon, considering the cost and large tretament period, must be cautious, reserving it only for confirmed remitting-relapsing modalities of MS. There is no clear cut evidence that beta interferon is useful for chronic-progressive MS
