Corticosteroid treatment reduces headache in eosinophilic meningitis: a systematic review

Sittichai Khamsai; Kittisak Sawanyawisuth; Vichai Senthong; Panita Limpawattana; Jarin Chindaprasirt; Pewpan M Intapan; Wanchai Maleewong; Somsak Tiamkao; Verajit Chotmongkol; Chetta Ngamjarus

doi:10.33393/dti.2021.2197

Authors

Sittichai Khamsai Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen - Thailand
Kittisak Sawanyawisuth Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen - Thailand
Vichai Senthong Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen - Thailand
Panita Limpawattana Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen - Thailand
Jarin Chindaprasirt Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen - Thailand
Pewpan M Intapan Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen - Thailand
Wanchai Maleewong Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen - Thailand
Somsak Tiamkao Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen - Thailand
Verajit Chotmongkol Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen - Thailand
Chetta Ngamjarus Department of Epidemiology and Biostatistics, Faculty of Public Health, Khon Kaen University, Khon Kaen - Thailand

DOI:

https://doi.org/10.33393/dti.2021.2197

Keywords:

Angiostrongylus cantonensis, Headache, Prednisolone

Abstract

Background: Eosinophilic meningitis (EOM) is an emerging parasitic disease that can be found worldwide, of which acute severe headache is a presenting symptom. Although such headaches may persist for up to 2 months, studies have found corticosteroid to be effective in reducing this symptom. As the most recent systematic review was published in 2015, the aim of this study was to provide a more up-to-date examination of the role of corticosteroids in EOM.

Methods: We included randomized controlled trials of corticosteroid treatment for EOM regardless of comparators. Research articles published in five databases were searched and evaluated. The primary outcome was headache, which was compared among various treatment regimens.

Results: We found a total of 257 articles after duplication removal. Of those, two met the study criteria. According to these studies, oral prednisolone alone or in a combination of albendazole resulted in fewer patients with headache after a 2-week course of treatment compared with placebo (maximum of 9.1% vs. 45.5%). The duration of headache was also shorter in the prednisolone arm vs. placebo (maximum of 5 vs. 13 days). There were no serious side effects reported.

Conclusion: A 2-week course of treatment with oral corticosteroid with or without albendazole reduced headaches in patients with EOM.

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References

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