Short regimen of praziquantel in the treatment of single brain enhancing lesions

Twenty-six patients with single enhancing brain lesion (SEL) were openly as signed to receive single-day praziquantel therapy (n= 14), or not (n= 12). From 14 treated patients, complete resolution was found in 11, partial reso lution in two, and the remaining case was later diagnosed as an arterioveno us malformation. Side effects presented in only one patient and remitted in the same day with symptomatic treatment. Conversely, the lesions persisted unchanged in sis of 12 patients in the non-treatment group. Untreated pati ents with persisting lesions were prescribed praziquantel treatment. After this, SELs disappeared in three cases, other diagnoses (brain tuberculoma a nd arteriovenous malformation) were made in two, and one was not evaluated. When analyzed in regard to the baseline serology, resolution of lesions on computed tomography was found in 13 (complete = 12, partial= 1) of 14 sero positive patients, whereas it only happened in six (complete = 5, partial = 1) of 13 seronegative patients. Serological screening defines a subset of SEL patients with good prognosis. If antiparasitic therapy is to be used in patients with SEL, and we cannot find a strong argument against it, single -day praziquantel is the regimen of choice based on duration, costs, and mi nimal side effects. (C) 2000 Elsevier Science B.V. All rights reserved.