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Tumor in the brain, said the doctors.
A photo of the tapeworm found in the brain of Rachel Palma. (Credit: Mount Sinai Health System)
After reviewing the exams and eliminating other possibilities, the cancer was the most likely explanation for the unusual symptoms that Rachel Palma experienced from January 2018.
"I had involuntary movements of the right hand, so I dropped objects," said the resident of Middletown, New York. "The worst symptoms were obviously hallucinations. And I have not always been oriented towards time and place. "
Once, Palma is locked out of her house and another time, her bank account.
"I could not handle the fact that a key opens the door. The computer screen looked completely different – it was almost alien, said the 42-year-old. "What I perceived was different and the way I answered was different: if someone asked for a pen, I would give him, for example, a key."
Sometimes she had happy days without symptoms. Without warning, falling things, hallucinations, disorientation would come back.
Brain injury found on a scanner
After January, her symptoms "progressed fairly quickly," she said, having visited the emergency department at least 10 times. "But as soon as they dismissed brain bleeding, I was discharged. Even though I was a danger to myself and probably to others, they still sent me away, "she said.
She understands why, since nobody could identify what was happening to her. "They said," If you do not bleed the brain, it's not an emergency, "she said.A convulsive disorder was also the subject of an investigation and was quickly fired.
During a brain scan, Palma's primary care physician detected a small lesion in the left frontal lobe of the brain and immediately sent it to Dr. Jonathan Rasouli, Chief Resident of Neurosurgery at Mount Sinai Hospital in New York. , and to his colleagues.
"We decided that it would probably be in her best interest to do a biopsy of this lesion," Rasouli said, basing herself on the fact that she was healthy and young and was showing symptoms that she was experiencing. it could directly correlate with the location of the lesion. In addition, she had no risk factor for anything that could explain the presence of a brain injury. Rasouli carefully explained the possibilities to his patient.
"It was said that it was most likely a malignant tumor requiring radiation therapy and chemotherapy even after the operation," Palma said.
The surgery would be risky because the location of his "tumor" was very close to the area of the brain that controls the speech.
Rasouli told CNN: "Her fiance had just made her request and they were looking to move in together. Suddenly, she had a diagnosis of a brain tumor. Can you imagine? "
Palma, however, believed the risk was worth it, "given that it was supposed to be a malignant tumor. I still think the risk was worth it. "
His first operation, essentially a "planning operation," explained Rasouli, took place on September 2, 2018. A second operation to remove the suspected tumor took place on September 12.
"We did a small dissection of the brain tissue and we saw that it was a very well encapsulated, firm and ovoid lesion," Rasouli said. "It looked like a quail egg: same size, same look, same firmness."
"Wait a second, it's clearly not a brain tumor," he recalls at the time.
When asked what a brain tumor looked like, he laughed, "It does not look like a quail egg. Most brain tumors are very soft, very soft, they are not very well defined, they are infiltrating and it is difficult to get around them completely. "
Rasouli quickly removed the lesion extracted from the operative field, placed it under a surgical microscope and opened it.
"And what came out was a baby tapeworm," he said.
How did he get there?
Neurocysticercosis is the medical term used to describe the pork tapeworm in the brain, said Rasouli. "If you live in the United States, it's almost impossible to get it."
Those most at risk are those who travel to countries where this pork tapeworm is endemic and eat contaminated food – usually raw fruit, raw vegetables or uncooked pork.
Rasouli said the tapeworm found in his brain "is not uncommon, it's rather rare. Maybe every two years you will see something like this, if even that. "
"There is absolutely no explanation as to how I contracted it," Palma said. She has never traveled outside the country and she does not eat raw food or raw meat, at least not intentionally, she said. How long it has been housed in her brain is another mystery, she says.
"We are still wondering how she developed this," Rasouli said. "If we had any suspicion that she might have been exposed to pork tapeworm or if we thought it was potentially a parasite, we would have ideally treated with antibiotics rather than doing it." operate."
Today, Palma has no symptoms and feels good. She thanked Rasouli and Mount Sinai medical staff for saving her life. If the tapeworm had not been removed (or destroyed with antibiotics), it could have caused a stroke or even death.
With all the attention – "for whatever reason, my story is fascinating to people" – Palma now has an important message to deliver: "This is not a topic of widespread panic. What has happened to me is extremely rare – it is not the norm – for someone who has not been abroad to contract that. "
While many people ask for medical advice, she gives her the only possible advice: "If you have symptoms that you can not explain or worry about, please consult a doctor. And see a good doctor.
"All headaches are not necessarily parasites."
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