Brain ‘worm’ cases worry doctors

BANGALORE: Vipul Sharma, a 34-year old banker, was healthy and hearty until last week when he fainted at his workplace. The condition of his heart was fine. His blood pressure and sugar level were normal. What went wrong with his health, his colleagues wondered, as they took him to the nearby hospital.

The doctors, who examined him, had an answer. He had tapeworm in his brain. The condition is medically termed as cerebral cysticercosis, more commonly known as parasitic infection.

City doctors say parasitic infection in brain is becoming common with hospitals getting at least two to three similar cases every week.

"Animals like pig are a definitive host of tapeworm. The larva comes to human body due to the intake of pork. If it is uncooked or not boiled adequately, the larva of the worm gets inside the human intestine, grows and, at times, moves up to the brain," said Dr Ramesh Raju, HOD of emergency ward of Manipal Hospital.

Sometimes, individuals get parasitic infections from their pets too, he said. 

However, Vipul was a pure vegetarian.

Doctors say 70 per cent of cerebral cysticercosis cases are found in people who live on greeens. Be it spinach, broccoli or cabbage, tapeworm can find a hiding place anywhere. Raw food and salads, if taken without washing or boiling, can help tapeworms enter human bodies.

Generally, taenia solium or pork tapeworm is the variety that causes parasitic infection.

"The larva gets inside the intestine and grows. While their head sticks to the intestinal wall, the worms start surviving on the food of the intestine and grow. These worms can grow real big and they form segmented body structure. Now each of these segments will have eggs. Later, the segments get detached from the tapeworm. The larva gets discharged inside the stomach, penetrates the intestinal wall and enters the blood stream," said Dr N K Venkatramana, neurosurgeon and vice-chairman, BGS Global Hospital.

Once the larva gets inside the blood circulation and spreads to various parts of the body including liver, muscles and brain, it gets calcified. Only in the intestine, the larva can survive on the food supply.

When it gets inside the brain, the larva starts irritating the surrounding area and results in the victim having fits. Cerebral cysticercosis can occur in three stages.

While the initial stage can restrict itself to swelling of the brain followed by severe headache, in the second stage, the patient suffers from epileptic attacks. Later, the symptom can be silent or lead to a long-term epilepsy.

“The third stage can be that of multiple cysts inside the brain that can lead to epcephalitis. This is a severe form of disease where the patient goes unconsciousness and needs intensive therapy. It can also cause death. This stage is known as cysticircle granuloma," Dr Venkatramana said.

At times, cyst can also be formed inside the spinal chord due to larva calcification.

Tell-tale signs
Headache
Vomiting
Loss of vision
Paralysis

Treatment
* Medical treatment of the cysts through medication and surgical approaches
* Treatment of the related complications