Rachel Palma’s symptoms were strange and disturbing: She was having hallucinations, insomnia and “horrific nightmares.” Her right hand would suddenly give way and she’d drop things. She was having trouble finding the right words and made alarming phone calls to her family that she didn’t remember.
“My episodes were getting more and more bizarre,” Palma, 42, who lives in Middletown, New York, told TODAY. “There were days that I didn’t know where I was.”
She’d been to urgent care several times after the trouble began early last year, but the cause remained a mystery. Finally, an MRI scan of her head caught doctors’ attention: It showed a lesion on the left side of her brain roughly the size of a marble.
The left side of the brain in right-handed people controls language and executive function, said Dr. Jonathan Rasouli, chief neurosurgery resident at the Icahn School of Medicine at Mount Sinai in New York City, who was part of the team that treated Palma.
Her lesion was located right next to the area of the brain that controls speech and it lit up brightly when the MRI was done with contrast, suggesting a malignant brain tumor, Rasouli added. Doctors counseled Palma that she was potentially facing a cancer that required surgery, chemotherapy and radiation.
“My husband and I were both in shock and we just wanted it taken care of,” Palma recalled when she heard the diagnosis. “I never really allowed myself to think that it was cancer.”
It turned out she was right.
When Dr. Raj Shrivastava, a neurosurgeon at Mount Sinai Hospital, and Rasouli opened her skull during surgery last fall, they expected to find a typical brain tumor: soft and spread out.
Instead, they saw “this very firm, very well encapsulated thing. It looked like a quail egg,” Rasouli recalled. They removed it in one piece and cut into it to see what was inside.
“Sure enough, a baby tapeworm came out of that lesion,” Rasouli said.
The medical team cheered with relief on behalf of the patient, knowing her prognosis was now much better than if they’d found a malignant brain tumor: “She had a single parasite in her head that we were able to take out — we were very happy.... It was one of those rare situations where you see a parasite and you’re like, wow this is great!”
A parasite in the brain sounds like the plot of a horror movie, but it’s a preventable infection from a pork tapeworm known as neurocysticercosis — a leading cause of adult onset epilepsy worldwide, according to the Centers for Disease Control and Prevention.
About 1,000 people are hospitalized for neurocysticercosis in the U.S. each year, with most patients coming from regions where the disease is common, including Latin America, the agency noted. Rasouli described it as “super rare” in the U.S.