RFK Jr. says he has a dead worm in his brain: Investigating neurocysticercosis
Key Takeaways
Robert F. Kennedy Jr. recently revealed he suffered from memory loss and mental fog in 2010, due to a parasite that ate part of his brain and then died there.
Parasites in the brain are rare, but pose real risks that can surface if handling undercooked meat with unwashed hands.
These worms can cause scarring to the brain and symptoms ranging from headaches and seizures to memory issues and death.
Robert F. Kennedy Jr. has allegedly been living with a parasite in his brain for over a decade.[] 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.
Then, one doctor told Kennedy that brain scans indicated he had a dead worm in his brain.
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.
The most common brain parasite is neurocysticercosis (NCC).[] NCC is a preventable parasitic infection caused by larval cysts from Taenia solium, a pork tapeworm.
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.
On a scan, the larval cysts may look like a tooth—or multiple teeth—says Clifford Segil, DO, a neurologist at Providence Saint John’s Health Center in Santa Monica, CA. Dr. Segil explains that when the larvae irritate the brain, they cause scar tissue and calcification—this calcified tissue can light up on a scan, making the condition easier to identify.
“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.[]
Dr. Sivakumar says that this may be “a little bit [of a] sensationalist” way of describing some of the impacts that Taenia solium larvae can have on the brain, including causing lesions, cysts, and inflammation.
“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.
Blockage of spinal fluid is one of the more severe consequences of an NCC, as this may lead to hydrocephalus, a neurological disorder characterized by pressure buildup in the brain and spine.[]
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.
Brain surgery may be considered if the cyst is causing injury to the brain or blocking spinal fluid or if cysts continue to form and new problems arise despite other treatment, Dr. Sivakumar says.
“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.[]
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.”
What this means for you
On rare occasions, people can develop parasites in their brain that can cause issues like headaches, seizures, mental fogginess, or problems with spinal fluid drainage—as is the case with 2024 presidential candidate, RFK Jr. The severity of these parasites can range widely and must be treated on a case-by-case basis. Brain parasites can typically be diagnosed through commonly used brain imaging scans like a head CT.