Tapeworm in Boston man’s brain triggered sudden seizures, case study says

BOSTON — Doctors at Massachusetts General Hospital weren’t quite certain what to make of a 38-year-old Boston man’s acute-onset seizures until brain scans revealed a longtime parasite had damaged three separate portions of his brain.

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Specialists determined through CT and MRI scans that the man suffered from neurocysticercosis, a preventable infection from a pork tapeworm known as Taenia solium, Today reported.

Unfortunately, in the absence of symptoms, the tapeworm wreaked unchecked havoc and left the man with lesions on the right frontal lobe, left occipital lobe and right temporal lobe of his brain, Live Science reported.

The case study was published in the Nov. 11 issue of The New England Journal of Medicine.

According to Today, the man showed absolutely zero advance signs of illness, with doctors writing that he took care of his children and dined with his brother, “displaying no unusual behavior,” prior to the acute onset of the seizures. He had no history of epilepsy.

The man’s wife alerted authorities after her husband fell out of bed, started shaking and “speaking gibberish” in the middle of the night. His disorientation and combativeness continued throughout his medical screening process, Today reported.

According to Live Science, people get infected with the parasite from ingesting the eggs of pork tapeworms in undercooked or infected pork. Those eggs can then hatch in the body, become larvae and travel around the body, including to the brain where they form cysts.

>> Related: Case study: Tapeworm larvae to blame for Australian woman’s chronic headaches

Meanwhile, the U.S. Centers for Disease Control and Prevention stated that an infected person can spread the tapeworm if they don’t wash their hands properly after going to the bathroom. Only about 1,000 people are hospitalized for neurocysticercosis in the United States annually, and the majority of those cases involve patients who relocated from rural areas of developing countries where the condition is more common.

According to the case study, the Boston patient had relocated from a rural area of Guatemala, where neurocysticercosis is prevalent, about 20 years before his abrupt display of symptoms.

“This gentleman was a little atypical, but not amazingly rare, in that his parasites were dead and calcified and there was no living parasite in his brain for one or two decades,” study co-author Dr. Edward Ryan, the director of global infectious diseases at Massachusetts General Hospital, told The Washington Post. “The infection was long gone, but part of his brain was scarred — and that scarred area was leading to the seizures.”

The parasites typically die in the body within five to 10 years, but they can continue to cause inflammation, leading to headaches, soreness and seizures, according to the newspaper.

The doctors treated the man with antiparasitic and anti-inflammatory drugs, and he was released from the hospital five days later, according to the study.

The doctors then followed up with the patient for the next three years, and the largest lesion in his brain has gone down, according to the Post. “He seems to be doing fine,” Ryan told the Post. “The good news is he continues to do well and be seizure-free.”

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