We thank Garg and colleagues for their letter. Two randomized trials compared albendazole and combination therapy with simultaneous praziquantel and albendazole. In both cases, the radiologic response was better with combination therapy only in patients with >2 viable parenchymal cysts but not in those with ≤2 cysts. These trials were the basis for the distinction in treatment of viable parenchymal disease distinguishing patients with 1 or 2 parenchymal cysts form those with ≥3 parenchymal cysts or viable parenchymal cysticercosis. However, neither of these trials included patients with >20 cysticerci.