Etanercept: A Potential Option in Refractory Complicated Neurocysticercosis

Excerpt

To the Editor: A 10-y-old girl presented two years back with chronic intermittent headaches and multiple episodes of focal seizures for 12 mo. Neuroimaging was suggestive of disseminated parenchymal neurocysticercosis (NCC). She was started on pulse methylprednisolone followed by oral steroids. Due to poor clinico-radiological response, weekly methotrexate was started and continued. She received two more doses of pulse methylprednisolone for acute disease flares in the third and sixth months of treatment. At this presentation, she had bilateral painless vision loss with altered sensorium for five days. Ophthalmological evaluation revealed bilateral optic atrophy. Due to unsatisfactory clinical response to steroids and methotrexate, weekly etanercept at 0.8 mg/kg/dose was initiated. The vision loss was attributed to occipital cortex edema. After six doses, she had a significant clinical response with complete recovery of bilateral vision and no recurrence of symptoms. She is currently on follow-up and is being planned for six more weekly cycles of etanercept, followed by slow tapering of corticosteroids. …