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Wednesday, Oct 16, 2019

Two tapeworms found inside the brain of a toddler in Haryana’s Mahendragarh

The girl was diagnosed with neurocysticercosis, a parasitic infection of the central nervous system caused by the accidental ingestion of eggs of taenia solium or pork tapeworm.

gurgaon Updated: Mar 17, 2019 04:04 IST
Sonali Verma
Sonali Verma
Gurugram
Two tapeworms found inside the brain of a toddler in Haryana’s Mahendragarh. (Representative Image)
Two tapeworms found inside the brain of a toddler in Haryana’s Mahendragarh. (Representative Image)(AP)
         

When a two-and-a-half-year-old girl in Mahendragarh district in Haryana had a sudden speech and motor arrest in late February, her family had no clue what was happening. Her parents said she couldn’t stand properly and wasn’t able to utter words despite trying hard for at least three to four minutes. “We knew something was wrong so we rushed to a local doctor who told us it was an epileptic seizure and asked us to refer to a hospital in Gurugram,” said Moni, the girl’s mother. Three days later, an MRI revealed she had two tapeworms inside her brain which had caused the seizure, and if not acted upon, it could result in brain damage.

The girl was diagnosed with neurocysticercosis, a parasitic infection of the central nervous system caused by the accidental ingestion of eggs of taenia solium or pork tapeworm. The girl is now on anticysticercal drugs to stop seizures, and is also taking an oral drug, to kill the worms. Her doctor said medication helps in expediting the process of their death, without which there is no certainty when they might die. Her medication for killing the worms will last for two weeks while the treatment for stopping seizures will continue for the next two years or so, said her doctor.

According to the World Health Organization, neurocysticercosis is the most frequent cause of epilepsy worldwide and is estimated to cause 30% of all epilepsy cases. It is also the most common cause of seizure or epilepsy in India and several other countries throughout the world, according to a 2016 research published in the Indian Journal of Medical Research.

An unusual feature of the disease is that more than 95% of Indian patients afflicted with the disease are vegetarians.Doctors said the disease occurs after ingesting raw or undercooked food, such as vegetables or meat, or through contaminated hands used in areas with open defecation.

“Although we can’t point to one specific reason, neurocysticercosis has always been associated with lack of sanitation and poor hygiene,” said Dr RK Jain, paediatric neurologist at Fortis Hospital where the disease of the girl from Mahendragarh was diagnosed. He said the worms release toxins when they start dying that causes swelling in the brain, leading to seizures.

“The worms had travelled to the girl’s brain through the bloodstream. Delayed treatment could have led to the worm travelling to the eyes leading to either damage of the retina or that of the brain,” he said, adding that the disease can cause more damage in infants than in adults as the brain of a child is still developing.

As per 2016 data on the National Health Portal of India, the disease is prevalent in all states of India, though the prevalence varies between the states. The website states it is highly prevalent in the northern states of Bihar, Uttar Pradesh and Punjab. It goes on to say, “In a rural pig farming community of Mohanlalganj block, Lucknow district, UP, the prevalence was found to be 18.6%. In the same community, active epilepsy was confirmed in 5.8% of the populations and 48.3% of people with epilepsy fulfilled the diagnostic criteria for the disease”. Data shows that in Delhi, neurocysticercosis accounted for 2.5% of all lesions (a region in an organ or tissue that has suffered damage through injury or disease).

However, Dr Jain said this is an infection which can be prevented by sanitation and hygiene. “Wash all fruits and vegetables under running water,” he suggested, adding that only well-cooked meat should be consumed. Washing hands with soap and warm water after using the toilet and before handling food is also essential.

First Published: Mar 17, 2019 04:04 IST

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