Editing Cysticercosis (section)

==Management==

===Neurocysticercosis===
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Asymptomatic cysts, such as those discovered incidentally on neuroimaging done for another reason, may never lead to symptomatic disease and in many cases do not require therapy. Calcified cysts have already died and [[Involution (medicine)|involuted]]. Further antiparasitic therapy will be of no benefit.{{cn|date=November 2020}}

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Neurocysticercosis may present as hydrocephalus and acute onset seizures, thus the immediate therapy is emergent reduction of intracranial pressure and [[anticonvulsant]] medications. Once the seizures have been brought under control, antihelminthic treatments may be undertaken. The decision to treat with antiparasitic therapy is complex and based on the stage and number of cysts present, their location, and the persons specific symptoms.<ref>{{cite journal |author=White AC |title=New developments in the management of neurocysticercosis |journal=J. Infect. Dis. |volume=199 |issue=9 |pages=1261–2 |date=May 2009 |pmid=19358667 |doi=10.1086/597758 |doi-access=free }}</ref>

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Adult ''Taenia solium'' are easily treated with [[niclosamide]], and is most commonly used in taeniasis. However cysticercosis is a complex disease and requires careful medication. [[Praziquantel]] (PZQ) is the drug of choice. In [[neurocysticercosis]] praziquantel is widely used.<ref>{{cite journal |author=Pawlowski ZS |title=Role of chemotherapy of taeniasis in prevention of neurocysticercosis |journal=Parasitol. Int. |volume=55 |issue=Suppl|pages=S105–9 |year=2006 |pmid=16356763 |doi=10.1016/j.parint.2005.11.017 |pmc=7108384 }}</ref> [[Albendazole]] appears to be more effective and a safe drug for neurocysticercosis.<ref name=Matthaiou08>{{cite journal |doi=10.1371/journal.pntd.0000194 |vauthors=Matthaiou DK, Panos G, Adamidi ES, Falagas ME |title=Albendazole versus Praziquantel in the Treatment of Neurocysticercosis: A Meta-analysis of Comparative Trials |journal=PLOS Neglected Tropical Diseases |volume=2 |issue=3 |pages=e194 |year=2008 |pmid=18335068 |pmc=2265431 |editor1-last=Carabin |editor1-first=Hélène}}</ref><ref>{{cite journal |doi=10.1056/NEJMoa031294 |author=Garcia HH |author2=Pretell EJ |author3=Gilman RH |author4=Martinez SM |author5=Moulton LH |author6=Del Brutto OH |author7=Herrera G |author8=Evans CA |author9=Gonzalez AE |author10=Cysticercosis Working Group in Peru |title=A trial of antiparasitic treatment to reduce the rate of seizures due to cerebral cysticercosis |journal=N Engl J Med |volume=350 |issue=3 |pages=249–258 |year=2004 |pmid=14724304 |url=https://researchonline.lshtm.ac.uk/5217/1/nejmoa031294.pdf }}</ref>  In complicated situation a combination of praziquantel, [[albendazole]] and [[steroid]] (such as corticosteroids to reduce the [[inflammation]]) is recommended.<ref>{{cite web|title=Taeniasis/Cysticercosis|url=https://www.who.int/zoonoses/diseases/taeniasis/en/|publisher=World Health Organization|access-date=6 February 2014|url-status=live|archive-url=https://web.archive.org/web/20140221163055/http://www.who.int/zoonoses/diseases/taeniasis/en/|archive-date=21 February 2014}}</ref> In the brain the cysts can be usually found on the surface. Most cases of brain cysts are found by accident, during diagnosis for other ailments. Surgical removals are the only option of complete removal even if treated successfully with medications.<ref name=gut>{{cite book |first=Yezid |last=Gutierrez |title=Diagnostic Pathology of Parasitic Infections with Clinical Correlations |chapter=26. Cysticercosis, Coenurosis, Sparganosis and proliferating Cestode larvae |chapter-url=https://books.google.com/books?id=oKSEhVMVrJ4C&pg=PA635 |year=2000 |publisher=Oxford University Press |isbn=978-0-19-512143-8 |pages=635–652 |edition=2nd}}</ref>

Antiparasitic treatment should be given in combination with [[corticosteroids]] and anticonvulsants to reduce inflammation surrounding the cysts and lower the risk of seizures. When corticosteroids are given in combination with praziquantel, cimetidine is also given, as corticosteroids decrease action of praziquantel by enhancing its [[first pass metabolism]]. [[Albendazole]] is generally preferable over [[praziquantel]] due to its lower cost and fewer drug interactions.<ref name=Matthaiou08/>

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Surgical intervention is much more likely to be needed in cases of intraventricular, racemose, or spinal neurocysticercosis. Treatments includes direct excision of ventricular cysts, shunting procedures, and removal of cysts via endoscopy.{{cn|date=November 2020}}

===Eyes===
In eye disease, surgical removal is necessary for cysts within the eye itself as treating intraocular lesions with anthelmintics will elicit an inflammatory reaction causing irreversible damage to structural components. Cysts outside the globe can be treated with anthelmintics and steroids. Treatment recommendations for subcutaneous cysticercosis includes surgery, praziquantel and albendazole.<ref name="eight" />

===Skin===
In general, subcutaneous disease does not need specific therapy. Painful or bothersome cysts can be surgically removed.{{citation needed|date=July 2020}}