This protocol applies to patients with neurocysticercosis presenting as a single enhancing lesion (SEL) — a cystic or nodular enhancing lesion less than 2 cm in size on neuroimaging. Antiparasitic therapy is recommended rather than observation alone for this presentation.
Radiologic resolution of the cystic lesion on MRI is the primary endpoint, evaluated at follow-up imaging by 6 months.
Management centres on antiparasitic therapy combined with corticosteroids, with the corticosteroid component initiated before the antiparasitic agent. Patients presenting with seizures require additional therapy. Full sequencing, agent selection, and monitoring details are available in the complete protocol.
We suggest albendazole therapy rather than no antiparasitic therapy for all patients with SELs (weak, moderate).
Cystic or nodular enhancing lesion <2 cm in size.
We recommend that patients with SELs treated with antiparasitic drugs also be treated with corticosteroids initiated prior to antiparasitic therapy (strong, moderate).
We recommend antiepileptic drugs for all patients with SELs and seizures (strong, moderate).
We suggest that MRI be repeated at least every 6 months until resolution of cystic lesions for patients with SELs (weak, low).
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