A rice farmer went to an emergency department after a one-minute episode of shaking in the right arm and leg. The MRI showed linear enhancement and a cluster of enhancing nodules with surrounding swelling in the left frontal lobe, the part of the brain that controls movement on the body's right side. The diagnosis was cerebral schistosomiasis, a parasitic worm infection that had reached the brain.
The case appeared as an Images in Clinical Medicine report in the New England Journal of Medicine from doctors at Jose R. Reyes Memorial Medical Center in Manila. The patient's job matters as much as the scan. The case was published after 2025, the year the Department of Health set for ending transmission in every endemic community, yet the parasite is still reaching people who work in flooded fields.
