2014
DOI: 10.1111/tmi.12421
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Nodding syndrome since 2012: recent progress, challenges and recommendations for future research

Abstract: We aim to review the current epidemiology of nodding syndrome (NS) and discuss relevant gaps in research. NS and convulsive epilepsy of unknown aetiology are clustered within the same villages and families in onchocerciasis-endemic areas. They are therefore potentially different clinical expressions of the same disease. It has been difficult to perform full autopsies on NS patients who die in remote villages. Adequate fixation of tissue immediately after death is critical for the examination of brain tissue. T… Show more

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Cited by 23 publications
(25 citation statements)
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“…39 It also cannot be excluded that epilepsy in patients with O. volvulus infection can be induced by immunological mechanisms, 40,41 by extracerebral factors leading to a disturbance of the blood-brain barrier, 42 or by a, so far unidentified, coexisting neurotropic factor found connected with O. volvulus transmission. 36,43,44 In summary, this report provides strong evidence that NS exists beyond the so far known endemic areas in Tanzania, South Sudan, and northern Uganda. Neurological investigations focusing on detecting cases of NS in other onchocerciasis endemic areas would be helpful in confirming this finding.…”
Section: Discussionmentioning
confidence: 97%
“…39 It also cannot be excluded that epilepsy in patients with O. volvulus infection can be induced by immunological mechanisms, 40,41 by extracerebral factors leading to a disturbance of the blood-brain barrier, 42 or by a, so far unidentified, coexisting neurotropic factor found connected with O. volvulus transmission. 36,43,44 In summary, this report provides strong evidence that NS exists beyond the so far known endemic areas in Tanzania, South Sudan, and northern Uganda. Neurological investigations focusing on detecting cases of NS in other onchocerciasis endemic areas would be helpful in confirming this finding.…”
Section: Discussionmentioning
confidence: 97%
“…sirbanum also breed along the Pager River northeast of Kitgum [43]. In addition, a member of the Simulium bovis species-group also forms a significant proportion of the anthropophilic blackfly population in the Mid-North [44]. Both S .…”
Section: Methodsmentioning
confidence: 99%
“…Onchocerciasis has also been suggested as causing nodding syndrome, an epileptic encephalopathy characterised by nodding of the head affecting mainly children in African regions endemic for onchocerciasis [31]. In several studies assessing the association with onchocerciasis, there is a trend towards higher positivity in cases than in controls [147] but this requires further investigations.…”
Section: Bacterial Infections As a Cause Of Epilepsymentioning
confidence: 99%