Transcript: Chronic Headaches and Pork Tapeworms
Neurocysticercosis is the infection of the human central nervous system by pork tapeworm larvae. Little, baby pork tapeworms invading one's brain has become an increasingly important emerging infection in the United States, and it is the #1 cause of epilepsy in the world. It is the most common parasitic disease of the human brain and use to only be found throughout the developing world—with the exception of Muslim countries of course. That all changed about 30 years ago, and now it's increasingly found throughout North America.
Besides seizures, the pork parasites may actually trigger brain tumors or cause an aneurism or psychiatric manifestation like depression, but who wouldn't be depressed having worms in their brain? It can also result in dementia, but the good news is that with deworming drugs it's often reversible. Only rarely do you have to open someone’s skull and extract the larvae surgically, though once they get into your eyeballs you really do have to remove them, dead or alive.
I've talked about pork tapeworms before, but what's new is that now we know that they may present as chronic headaches—either migraines or so-called tension-headaches—even when the worms in your head are dead. What they think is happening is that as our body tries to chip away at their calcified bodies it may release bits of them into the rest of our brain causing inflammation that could be contributing to headaches.
Now it's still rare, and even if you live in an endemic area you can avoid getting infested with an adult tapeworm in the first place by cooking pork thoroughly, but what does that mean exactly? Well first of all it's found in some parts of pig carcasses more than others, and you can freeze the little suckers to death,no matter how infested the muscles are, by storing pork cut up into small pieces for a month at subzero temperatures. Then cook the meat for more than two hours. That is one well-done pork chop.
The New England Journal of Medicine recently featured a case of some guy who must have had thousands of pork tapeworm larvae wriggling through his muscles. See all those little white streaks? That's why you can get infected by pork, it gets in the muscles. So cannibals might want to cook for two hours too.
Not all parasites are associated with meat, though. An anxious but healthy 32-year-old male physician presented to the family medicine clinic with a sample of suspected parasites from his stools, which had been retrieved from the toilet that same day. And here they are. They look to be about an inch long. He had previously traveled to India, had Chinese food the night before—who knows what he had. Maybe it was hookworms? The sample was sent to the microbiology laboratory for analysis.Later that day, the microbiology physician called to report positive identification of Vigna radiata (previously known as Phaseolus aureus) in the stool sample. Or in common parlance, a bean sprout. They were bean sprouts!
"The patient was called and gently but firmly informed of the diagnosis. Given the nature of the identified specimen, the information was presented in a non-judgmental, respectful manner so as not to offend the sensibilities or sensitivities of the patient."
Their parting advice to fellow physicians in cases of this nature would be as follows: as comical as the findings might seem--try not to laugh!
To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video. This is just an approximation of the audio contributed by Ariel Levitsky.
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