My migraines kept getting worse for months. Then doctors made a horrifying discovery in my brain... and traced it to my breakfast
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A man who was experiencing a persistent, and worsening, migraine was shocked to find that his pain was actually due to a tapeworm that had infected his brain through one of his favorite foods.
The 52-year-old unidentified patient had a history of migraines but had noticed that for the previous four months, the headaches had become more frequent, occurring almost weekly and becoming more severe.
They also weren't responding to his usual medications.
Out of an abundance of caution, doctors ordered a CT scan of his head, which revealed multiple fluid-filled areas in the white matter - the brain's communication network - throughout his brain.
Unsure of what the cysts were, doctors urgently admitted the patient to the hospital for further neurological evaluation, but lab tests revealed nothing of note. However, an MRI showed edema, excess fluid where there shouldn't be, which can dangerously increase pressure in the brain.
Doctors became suspicious of a condition called neurocysticercosis, a parasitic infection caused by a pork tapeworm. The patient was then referred to infectious disease specialists.
Testing confirmed neurocysticercosis.
The infection is caused by the larval form of the taenia solium, a pork tapeworm that uses pigs as intermediate hosts. Humans contract the worm when they ingest cysts in infected pork or feces.
The man told his doctors his migraines had been getting worse over the previous four months and his usual medications were not working (stock image)
Image A is a CT scan of the patient's brain that shows clusters in the right side of the organ. Image B shows cystic lesions seen on an MRI. Image C shows cystic lesions in the corpus callosum (orange arrow) and occipital lobe (yellow arrow)
While the condition is endemic in poorer, developing countries because of limited sanitation, it is rare in the US, with an estimated 1,300 to 5,000 new cases per year.
The patient, whose resurfaced case was reported in the American Journal of Case Reports, said his only recent travel was on a cruise to the Bahamas two years prior. He said he did not eat raw food but 'admitted to a habit of eating lightly cooked, non-crispy bacon for most of his life.'
To treat the tapeworm, the man was given two oral medications to take twice and three times daily for two weeks.
On the medications, his headaches improved and further scans showed a regression of the fluid-filled areas in his brain.
The authors of the case report linked the man's bacon habit to his neurocysticercosis as the condition is 'virtually nonexistent in areas of the world that have banned pork consumption, further highlighting the strong link between swine and this disease.'
It does, however, remain prevalent in Asia, Latin America, sub-Saharan Africa and Oceania.
And while it is rare in developed countries, the authors wrote that 'increased rates of immigration to developed countries from endemic countries have led to a significant increase in prevalence in countries such as the United States.'
However, the authors caveated, the patient's tendency for soft bacon would have more likely led him to develop taeniasis, an intestinal tapeworm, not neurocysticercosis.
The authors of the case report linked the man's bacon habit to his neurocysticercosis
This led the authors to conclude: 'It can only be speculated, but given our patient’s predilection for undercooked pork and benign exposure history, we favor that his cysticercosis was transmitted via autoinfection after improper handwashing after he had contracted taeniasis himself from his eating habits.'
The doctors believed that the tapeworm infected the man's gastrointestinal tract and then through exposure to his contaminated feces, the worm infected his brain.
Patients with neurocysticercosis typically suffer from seizures, but this patient did not report any.
While migraines are not a common presentation of neurocysticercosis and typically do not prompt doctors to order brain scans, the doctors authoring the case report said 'changes in migraine frequency or character should raise concern for a new pathology, as in our patient.'
They added: 'Clinicians should retain a high index of suspicion and obtain thorough histories in patients with changes in migraine pattern, as etiologies that are considered unlikely may become more probable if there are high-risk features such as travel to endemic countries or occupational exposures.'
Daily Mail
