Treatment is usually supportive with the use of analgesics for pain and corticosteroids to limit the

inflammatory reaction. Careful removal of CSF at frequent intervals can help to relieve headache in
patients with elevated intracranial pressure. No anti-helminthic drugs have been proven to be effective
in treatment, and there is concern that anti-helminthics could exacerbate neurological symptoms due
to a systemic response to dying worms. The effectiveness of any regimen may vary by endemic
region. One randomized, placebo-control study of a 2-week course of prednisolone (60 mg per day in
3 divided doses) found that the corticosteroids reduced the median length of headache from 13 days
to 5 days and reduced the need for repeat lumbar puncture. Additionally 9.1% of treatment patients
compared to 45.5% of controls still had headache at 2 weeks.
In two small cases series (41 and 26 adults, respectively) adult patients were given prednisolone 60
mg/day and an anti-helminthic (mebendazole 10 mg/kg/day or albendazole 15mg/kg/day two weeks,
respectively), resulting in resolution of headache in a median of 3 days in the mebendazole caseseries and 4 days in the albendazole case-series without serious side effects. As there was no control
group, it is difficult to determine if the anthelminthic provided additional benefit. Comparing the
results from the placebo-control trial to the 2 case-series, 9.1% of prednisolone monotherapy
patients, 9.8% of prednisolone-mebendazole patients, and 11.5% of prednisolone-albendazole
patients still had headache after 2 weeks. One small trial that directly compared prednisolone
monotherapy to prednisolone-albendazole combined therapy found no benefit of adding albendazole to
the regimen.
Additional symptomatic treatment may also be required for nausea, vomiting, and in some cases
chronic pain due to nerve damage and muscle atrophy.