Tapeworms in brain reason behind man's altered mental status and unexplained seizures, study reveals

A 38-year-old man from the United States was admitted to a hospital because of altered mental status and a seizure, which happened due to the presence oftapeworms in his brain as per a case study published in The New England Journal of Medicine on November 11.

The man from Boston, whose name hasn't been made public, was taken to the hospital after his wife reported that he fell out of bed at approximately 4:00am (local time) and was "shaking" on the floor, also speaking"gibberish". He appeared to be confused and disoriented.

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In an immediate response, police were called to the patient's apartment and emergency medical services were activated. He was taken to the Massachusetts General Hospital, where doctors conducted various examinations,runningtests and scans.

"The patient was combative and disoriented, and he actively resisted being placed in the ambulance. On arrival at the emergency department, he had a witnessed generalized tonic–clonic seizure, lasting 2 minutes, for which lorazepam was administered intravenously," a part of the study read.

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Scanning of the brain suggested neurocysticercosis is the most likely diagnosis in this case as there was swelling and three lesions in his brain. The symptoms were typical of a parasitic infection known as neurocysticercosis, which can cause seizures and headaches and sometimes lead to death.

The case study further revealed that the patient was treated with antiparasitic and anti-inflammatory drugs and was discharged on the fifth day of the hospital, with normal results on a neurologic examination and no further seizure activity.

According to theUSCenters for Disease Control and Prevention, A person can get cysticercosis by "swallowing eggs found in the feces of a person who has an intestinal tapeworm."CDC also informed that the highest rates of cysticercosis arefound in areas that have poor sanitation and free-range pigs that have access to human feces.

Patient's history

The report mentioned that the patient had appeared well the day before the seizure and there's no evidence of a provoked event in this patient's history or examination.

Also, there is no evidence of a previous neurologic, medical, or psychiatric condition that would have put him at increased risk for seizures.

What possibly can be the reason is, he had emigrated from a rural area of Guatemala, which could have been the endemic infectious diseases that could have increased this patient's risk for seizures even years after exposure, such as parasitic brain infection.

Cysticercosis

The study had revealed that Cysticercosis is the most common cause of acquired epilepsy worldwide. The disease results from the ingestion of eggs from the tapeworm.

This disease is endemic in areas of Asia and Central America; in these areas, 10 to 50% of patients with epilepsy have evidence of neurocysticercosis on cerebral imaging.

There are also locations in the United States where cysticercosis is highly prevalent, including Southern California, Texas, and New York City.