Nodding syndrome
Nodding Syndrome is a neurological condition characterized by a nodding behavior of the head, accompanied by other forms of seizures, cognitive decline, and stunted growth. The syndrome primarily affects children between the ages of 5 and 15, and is most commonly reported in certain regions of East Africa, including South Sudan, Tanzania, and Uganda.
Etiology
The exact cause of Nodding Syndrome is unknown. However, it is believed to be associated with Onchocerca volvulus, a parasitic worm that causes onchocerciasis, or "river blindness". This association is based on the high prevalence of onchocerciasis in the regions where Nodding Syndrome is endemic. Some researchers also suggest a potential role of nutritional factors and exposure to wartime chemicals.
Clinical Features
The hallmark feature of Nodding Syndrome is a repetitive dropping forward of the head, which often begins when the affected child is eating or feeling cold. These nodding episodes can vary in frequency and duration. Over time, the syndrome progresses to include other types of seizures, cognitive impairment, behavioral changes, and physical stunting.
Diagnosis
Diagnosis of Nodding Syndrome is primarily based on clinical features. There are no specific laboratory tests for the condition. Neuroimaging studies, such as MRI and CT scan, may show brain atrophy.
Treatment
There is currently no cure for Nodding Syndrome. Treatment is supportive and focuses on managing seizures and improving quality of life. Antiepileptic drugs, such as sodium valproate and carbamazepine, are commonly used. Physical and occupational therapy may also be beneficial.
Epidemiology
Nodding Syndrome is most prevalent in certain regions of East Africa, particularly among communities affected by onchocerciasis. The first cases were reported in Tanzania in the 1960s. Large-scale outbreaks have since been reported in South Sudan and Uganda.
Research
Research into Nodding Syndrome is ongoing. The World Health Organization and the Centers for Disease Control and Prevention are among the organizations conducting studies to better understand the condition and develop effective treatments.
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External links
- Comprehensive information from the National Institute of health.
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Contributors: Prab R. Tumpati, MD
