According to researchers, a man hospitalized with mysterious seizures and an altered mental status had Tapeworms living in his brain for decades. In a case study published last week in The New England Journal of Medicine, experts from Massachusetts General Hospital and Harvard Medical School said the 38-year-old man was initially evaluated following his first seizure and had been speaking gibberish.
The man, who had immigrated from rural Guatemala, was combative and disoriented until he arrived at the hospital, where he had a witnessed generalized tonic-clonic seizure. Although the patient’s eyes were open, he did not verbally respond to questions or follow commands with an involuntary upward gaze.Gag and cough reflexes were normal, and the man had no history of illness, medication, or drug use and rarely drank alcohol. The doctors gave him two doses of lorazepam administered intravenously seven minutes apart, and an endotracheal tube was placed for airway protection.
A chest radiograph taken was normal, and the team eventually diagnosed the patient, noting in the study that among patients presenting with an apparent first seizure, obtaining the clinical history is key. Laboratory testing ruled out hyponatremia, renal dysfunction, and liver dysfunction, and the man’s urine and serum toxicology panels were negative. However, further evaluation revealed leukocytosis and lactic acidosis.
Cole also noted that electroencephalography (EEG), which is “extremely useful in classifying the seizure problem,” is rarely performed rapidly in the emergency department. Cole wrote that cysticercosis is the most common cause of acquired epilepsy worldwide, resulting from the ingesting of Tapeworms eggs.