Robert F. Kennedy Jr. has allegedly been living with a parasite in his brain for over a decade.

Craig S. R.F.K. Jr. Says Doctors Found a Dead Worm in His Brain. The New York Times. May 8, 2024.

The presidential candidate reported experiencing symptoms of memory loss and mental fogginess in 2010, causing a friend to wonder if he had developed a brain tumor. Kennedy then saw several doctors, some of whom agreed that a tumor was present, but a consensus was not reached.

 

 

 

Brain parasite risks

 

Neurologists say that brain parasites are rare but pose real risks. Walavan Sivakumar, MD, a board-certified neurosurgeon and the director of neurosurgery at Pacific Neuroscience Institute, South Bay in LA, says that these infections are less common in the US than in developing countries; however, case numbers in the US have been increasing in recent years, likely due to increased incidences of people undergoing imaging studies.

 

According to the CDC, a person can get NCC from eating undercooked infected pork, passing the tapeworm through their body into their feces. If people don’t properly wash their hands after using the bathroom, they can contaminate food or surfaces with feces containing eggs from the tapeworm. Once in the body, these eggs can make their way into the infected person’s brain, causing NCC cysts.

Depending on how many and where in the brain they are located, Dr. Sivakumar says, the cysts can cause a range of immediate and long-term health impacts, including headaches, seizures, inflammation, increased pressure, problems with spinal fluid drainage, confusion, and mental changes.

 

Diagnosing a brain parasite

 

Brain parasites can be diagnosed through common imaging scans, such as a head CT.

“What happens is you get these CTs and they look like there's a tooth in the brain, but it's just actually scar tissue,” Dr. Segil says.

These structures typically imply that the parasite is already dead—and benign—Dr. Segil explains. However, complications can still occur. The more “teeth” visible on a scan, the more problemsome the case may be, he says.

“You can have one or you can have 10, or you can have 20, or you can have 30,” Dr. Segil says. “And if you have more than 10, the risk is you can have seizures.”

 

Symptoms of brain-eating parasites

 

In a deposition reviewed by The New York Times, Kenney said that a doctor believed his parasite “ate” a portion of his brain.

Craig S. R.F.K. Jr. Says Doctors Found a Dead Worm in His Brain. The New York Times. May 8, 2024.

 

“The brain recognizes that [the parasite is] not part of its own body, and then there's an inflammatory response to that,” Dr. Sivakumar says.

Immediate symptoms

The parasite’s inflammatory impact on the brain may cause immediate or short-term symptoms like headache or seizures.

If a patient is experiencing a headache, they could be experiencing a brain parasite; however, this is not the most likely explanation, so you may not need to conduct an imaging scan right away, Dr. Sivakumar says. If symptoms do not subside, or more occur, you may want to conduct testing.

Longer term symptoms

Long-term symptoms are also possible. Whether or not someone experiences these symptoms—and to what extent—can depend on the parasites’ size, number, life cycle, and location, as well as the duration of the infection, Dr. Sivakumar says.

Some potential long-term symptoms include, confusion, mental fog, memory loss, and the blockage of spinal fluid.

 

Hydrocephalus is a serious condition that can be fatal without treatment—which may involve surgery—Dr. Sivakumar says. 

 

Treating brain parasites

 

Like the infection’s symptom presentation, treatment for brain parasites varies. 

“Once the parasite is already there, to prevent some of the worse outcomes, treatment depends on what specific problem you have and where in the brain this parasite is,” Dr. Sivakumar says.

Potential treatment options include:

• Anti-seizure medications

• Medical therapy to kill the parasite, which can include antihelminthic drugs like albendazole

• Surgery to remove the cyst

Surgery is not recommended for everyone and is not possible in every case. 

“Depending on where the actual cyst is, and with advancing, minimally invasive surgical techniques, we're finding it more feasible to access deep regions in the brain safely,” Dr. Sivakumar adds. “If it goes well, patients could be as if it never happened.”

Dr. Sivakumar explains that while brain surgery has become increasingly successful with new technology, “it is still brain surgery,” and therefore not risk-free. There are a couple different surgical options for cyst removal, including the use of endoscopes.

Panigrahi M, Gupta B, Reddy R. Neuroendoscopy - Is it safe? Asian J Neurosurg. 2017 Jan-Mar;12(1):17-21. doi: 10.4103/1793-5482.145567. PMID: 28413526; PMCID: PMC5379797.

 

 

Prevention

 

The CDC describes NCC as a “preventable parasitic infection,” and neurologists agree. Keeping up with handwashing, oral hygiene, and safe cooking practices are key ways you can encourage patients to keep themselves safe.

“From a transmission standpoint, it's a preventable thing,” Dr. Sivakumar says. “The main—and a very easy—way to prevent it is to practice good handwashing. That's the key.”