A 38-year-old man in Boston went to the hospital with unexplained attacks. It turned out he had been living with a dead tapeworm in his brain for years, according to a new case report.
The man’s wife called police after her husband fell out of bed, began shaking and “talking babel” in the middle of the night. When help arrived, the man was “combative” and “disoriented,” and he resisted getting into an ambulance, according to the report.
When he arrived at Massachusetts General Hospital in Boston, he had another unexplained attack. It was not immediately clear what caused the epileptic seizures, as he had no previous history of them, or of any related disorders.
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Doctors at the hospital gave the man medication to check his epileptic seizures and made various attempts. Brain scans revealed swelling and three injuries in his brain – both of which are typical of a parasitic infection known as neurocysticercosis, which can cause epileptic seizures and headaches and sometimes lead to death.
Humans become infected with the parasite by ingesting the eggs of pig tapeworm (Taenia solium) in undercooked or infected pork. These eggs can then hatch in the body, become larvae and travel around the body, including the brain where they form cysts. An infected person can spread tapeworm if they do not wash their hands right after going to the bathroom; if that person contaminated food or surfaces with their hands, others could then catch the parasitic infection, according to the Centers for Disease Control and Prevention (DISEASE CONTROL CENTER).
Pig tapeworm infections are most common in rural areas of developing countries where pigs roam freely and eat human feces, According to the Centers for Disease Control. But about 1,000 people are hospitalized for neurocystic heart disease in the United States each year, most of whom have been in other countries where these tapeworms are more common.
About 20 years ago, the patient in the case report relocated to Boston from a rural area of Guatemala, where the infection is widespread, according to the report.
“This gentleman was a bit atypical, but not surprisingly rare, because his parasites were dead and calcified and there hadn’t been a living parasite in his brain for a decade or two,” study co-author Dr. Edward Ryan, the director of Global. infectious diseases at Massachusetts General Hospital, told The Washington Post. “The infection had long since disappeared, but part of his brain was scarred – and that scarred area caused the attacks.”
The parasites usually die in the body within five to 10 years, but they can continue to cause inflammation, leading to headaches, pain and epileptic seizures, according to the Post.
The doctors treated the man with anti-parasitic and anti-inflammatory drugs, and he was released from the hospital five days later, according to the study. The doctors followed the patient for the next three years, and the biggest injury in his brain diminished, according to the Post. “He seems to be doing well,” Ryan told the Post. “The good news is that he’s still doing well and is headless.”
The findings were published on November 11 in The New England Journal of Medicine.
Originally published on Live Science.