A Florida man’s agonizing migraines turned out to have a terrifying cause: actual brainworms. In a recent case study, his doctors describe how he developed a parasitic infestation of tapeworm eggs in his brain, possibly caught from eating undercooked bacon. Thankfully, the man was successfully treated.
The strange medical tale was detailed last week in the American Journal of Case Reports. It was written by doctors from the University of South Florida and the Orlando Regional Healthcare System.
According to the report, the 52-year-old man had a past history of chronic migraines. But by the time he visited the doctors at an outpatient clinic, he had been experiencing more severe and frequent headaches for four months—headaches that no longer responded to the usual treatments.
Given this new pattern of migraines, the doctors decided to run a CT scan of his head. And that’s when they discovered the clear presence of cyst-caused lesions on both sides of the brain. Further tests ruled out other causes and confirmed that the man had contracted a particular form of pork tapeworm (Taenia solium) infection: neurocysticercosis.
There are two types of pork tapeworm infection. If we ingest larval tapeworm cysts found in pork or other undercooked meat, they can migrate to our intestines and grow into full-blown adult tapeworms. These worms can cause gastrointestinal illness and weight loss, though people will often never experience symptoms. The worms will also produce eggs that get pooped out. And if the eggs eventually infect pigs or other host animals, the life cycle starts all over.
But if another person or even the same infected person then ingests these eggs, the new generation of worms reaches a dead end and can only mature into their cyst form of life. The cysts can then cram their way into different parts of the body, including the brain, and eventually cause a whole new round of trouble. Though brain tapeworm infections are rare in the U.S., they’re a leading cause of seizures in adults worldwide, and cysticercosis in general is considered a neglected tropical disease.
The infected man reported no recent travel history to areas of the world where people are at higher risk of tapeworms, nor a history of eating raw or street vendor food. But he did admit to regularly eating lightly cooked, non-crispy bacon, which appears to be the most likely culprit for his predicament.
At some point, the doctors suspect, the man caught tapeworms from eating undercooked bacon, then gave himself a second bout of tapeworm cysts from not properly washing his hands after going to the bathroom. Assuming that scenario is correct, it’s a very unusual one, they note, since tapeworm-infected pork is now rare in the U.S. (most cases are caught while traveling).
While seizures tend to be the most recognizable symptom of neurocysticercosis, it can trigger a wide range of subtler neurological problems. So doctors should at least consider the possibility of neurocysticercosis as a cause for acute migraine changes in their patients, the report authors say, even when classic risk factors like travel aren’t in the picture.
As for the unlucky man, he was treated with steroids and antiparasitic medication, which appear to have reduced his headaches and the brain lesions caused by the tapeworm cysts.
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