Can you get epilepsy from a tapeworm?

Posted on 18 December 2017

Eating raw or undercooked pork is highly risky for your health, not only because of the likelihood of bacteria in the meat, but also for the chance of picking up tapeworm.

Cysticercosis is a parasitic disease caused by ingesting the larvae of the pork tapeworm Taenia solium. The tapeworm lives in the small intestine of humans, and can be up to 4m long. If the infected larvae invade your nervous system, the condition will develop into neurocysticercosis, which can lead to seizures and epilepsy.

Often regarded as a “disease of neglect”, neurocysticercosis certainly can be avoided through good food hygiene. The cycle is simple: pigs become infected with the parasite when they come into contact with the faeces of infected people. When pigs ingest the larvae, they become infected, and should that pork not be thoroughly cooked when consumed, the larvae enter the human body.

Recognised by the World Health Organisation as the food-borne parasite of “greatest global concern”, neurocysticercosis is the most common preventable cause of epilepsy in the developing world. The disease is endemic in south and south-east Asia, and in parts of sub-Sarahan Africa, particularly in rural areas where community farming practices allow free-roaming pigs to come into contact with human faeces.

Once the eggs hatch, the parasites penetrate the gut wall and then spread to the organs through the blood. The infection can spread to the muscles, the eyes and, most commonly, to the brain, resulting in seizures. Symptoms of neurocysticerosis can include chronic headaches, blindness, seizures, meningitis, weakness on one side and dementia.

Diagnosis of the condition requires computed tomography (CT) scans. Usually such technology is not available in remote rural areas, where the disease tends to be most prevalent, so the disease is difficult to identify and treat.

Dr Eulenda Skosana, a neurologist at practising Muelmed, says the clinical presentation of neurocysticerosis depends on the number of parasites in the body, their location, what stage they are in their lifecycle, and the immune response of the host. Patients with a ventricular (cavity in brain) infection have worse immune responses than those with parenchymal brain infection.

‘Patients with the active disease need to be treated with anti-parasites medication. Steroids may be given to reduce the brain swelling which usually takes place when the parasites die. Surgical intervention is reserved for those patients with intraventricular infection,’ explains Dr Skosana.

‘Patients with the inactive disease (calcified), usually go on to have seizures, and should be treated with anti-seizure medications.’

‘As with all diseases, prevention of neurocysticercosis is better than cure. Adequate cooking of pork at 50°C or freezing at -20°C kills the parasite. Proper sanitation is critical, washing of vegetables in clean water is important, and proper pig farming practises will help to eradicate the disease completely.’