Tapeworm in brain causes epilepsy

Meat should be properly cooked. Experts have warned that eating undercooked meat from pigs exposes people to the danger of contracting pig tapeworm, whose eggs can mature into larvae which travel to the brain and induce epileptic fits.
Good hygiene, like washing hands before eating, can prevent epileptic seizures that are
caused by tapeworm eggs that get lodged in the brain. This is a cheap solution to preventing cases of epilepsy caused by an avoidable food-borne parasite, which the World Health Organization (WHO) said accounts for almost one-third of the world’s epilepsy cases.

Despite the fact that epilepsy is the most common of the brain disorders, it remains both feared and misunderstood. In epilepsy, there are disturbances in the normal activity of the brain, causing strange sensations and seizures. The terms seizure, fit and convulsion are often used to describe the same thing. And although the seizures will cease in half of childhood cases, it’s a life-long disorder for the rest. However, epilepsy has many possible causes, such as abnormal brain development, stroke, illness, brain damage, illness of the mother during pregnancy and meningitis, among other causes.

Roughly one person in every 200 will experience a seizure at some point in their life. Seizures can occur at any stage, but are more common in the first 20 years of life and in elderly people. More than half of all those who develop epilepsy have their first attack by the age of 15.

The infections that most commonly affect the brain are AIDS, meningitis and tuberculosis. However, scientists at the National Institute of Allergy and Infectious Diseases (NIAID), Maryland, USA, in 2008 discovered that a tapeworm may cause epilepsy in a slightly different way. The larvae of tapeworm from undercooked infected pork become lodged in the brain, and here they can form dead, calcified cysts. This is known as neurocysticercosis.

Neurocysticercosis (NCC), an infection of the brain, is the most common cause of seizures and epilepsy in developing countries, where pig tapeworm is endemic. This infection of the brain is common in areas with poor sanitation. This parasite can live for years, sometimes for entire life-times, in the brains of humans who can be free of symptoms, but in general the most common symptoms include epileptic attacks, headaches, visual and skin problems, and psychiatric manifestations.

Eating raw or undercooked meat from pigs infected with tapeworm larvae allows the worm to develop in the intestine and shed eggs, which are passed in human faeces. The eggs are ingested, either by pigs or humans, through contaminated food. They then mature into larvae which travel to the brain and cause cysts, inducing seizures.

But the size of the link has surprised experts. A preliminary finding of a WHO-sponsored review of the global burden of epilepsy resulting from NCC infection found that 30 per cent of all people suffering epilepsy in countries where tapeworm is common also suffer from NCC.

Dr. Bola Orimadegun, a peadiatricain with the Institute of Child health, University College Hospital (UCH), Ibadan, Oyo State, declared that many worms that people contract through contaminated food or water wreak havoc in the human body and that one of them is tapeworm.

Explaining why worms like tapeworm can cause epilepsy, he declared: “What usually happens is that that the worm migrates to the brain and then settles down in a part of it, causing a problem in the functioning of the brain.”

According to him, although epilepsy is an abnormal functioning of the brain that many people misinterpret as just someone jacking and foaming from the mouth, however, tapeworm is just one of the rare causes of epilepsy.

“Most epilepsy cases are of unknown origin in Africa, but for children, the majority of epilepsy cases are traceable to events around the time of their delivery and I think this is what efforts should concentrated on in a bid to reduce new cases of epilepsy,” he stated.

He explained: “Events during pregnancy, at the time of labour and immediately after birth, can predispose a child to developing epilepsy later in life. For instance, during pregnancy, if the mother is exposed to infections like rubella, it can cross through the placenta, the cord attaching the baby to the mother, to affect the unborn baby. During labour and birth, if delivery is unsupervised by a trained expert, the child may be delivered with some birth injury to the immature brain. The brain injury could be as a result of the child suffering deprivation of oxygen. So that may be the origin of epilepsy in some situations.

“In addition, infections like jaundice and meningitis, an infection of the covering of the brain, could be responsible for epilepsy in children, as a complication of these diseases. So, there are several things that are purely preventable, which cause epilepsy.”

Dr. Ike Lagunju, a consultant pediatrician at the UCH, Ibadan, said much as tapeworm could cause epilepsy, it is, however, rare in Nigeria. According to her, “it is a known fact that you can have tapeworm moving from the intestine going into the brain, but you see more of it in South Africa and other parts of Africa.”

She declared that sometimes when the worm is in the brain, ”it behaves like a tumour. It sits in the brain, takes up space, exerts pressure and then you find the patient coming down like a patient with a brain tumour.”

In addition, she pointed out that it was also a major cause of epilepsy in some developing countries, particularly, adult onset epilepsy. “You find this tapeworm in the brain and then the patient develops fits or convulsions that occur repeatedly, which we know as epilepsy. We have seen a few cases and you are able to make diagnosis when you do medical tests such as brain scan, computer tomograpy scan and magnetic resonance imaging.”

Although, this is rare cause of epilepsy, Dr. Lagunju stated, once such is detected, the individual would be treated with medicine and the invading parasite in the brain removed by surgeons.

Meanwhile, head injuries during road accidents could turn out to be a primary cause for the increasing incidence of epilepsy and that is why people riding two-wheelers should wear helmets. Also, a precautionary measure to prevent epilepsy should include adequate pre-natal care during a delivery to help rule out new cases of epilepsy caused by birth injuries. Epilepsy can be treated with the help of anti-epileptic drugs, so prompt medical examination and treatment should be a priority.

It is not only tapeworm that wants to “eat” the human brain, causing epilepsy. Others are Naegleria fowleri, a freshwater amoeba and Toxoplasma gondii, a protozoan found in cats and rodents.