The drug of choice for neurocysticercosis (viable parenchymal cysts on MRI with perilesional oedema) in an adult is:

• A Praziquantel alone for 15 days
• B Ivermectin 200 µg/kg single dose
• C Niclosamide 2 g single dose
• D Albendazole 15 mg/kg/day for 8–30 days combined with corticosteroids ✓

Explanation

For viable parenchymal neurocysticercosis, albendazole (15 mg/kg/day in two divided doses, up to 800 mg/day) for 8–30 days combined with dexamethasone (to suppress the inflammatory reaction from dying cysts) is the recommended treatment. The combination of albendazole + dexamethasone is more effective than praziquantel + dexamethasone in several trials, particularly because praziquantel levels are reduced by concurrent dexamethasone and rifampicin. Ivermectin is used for onchocerciasis, strongyloidiasis, and filariasis. Niclosamide is for intestinal tapeworm (not NCC).

Reference: Ananthanarayan & Paniker's Textbook of Microbiology, 11th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.