☆ 4.5 Article

The onchocerciasis hypothesis of nodding syndrome

PLOS NEGLECTED TROPICAL DISEASES (2023)

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Summary: This article describes the clinicopathologic spectrum of nodding syndrome in northern Uganda. All 16 cases had chronic seizures, and seven cases also had progressive cognitive, behavioural, and motor decline. The main neuropathologic findings included tau pathology, cerebellar degeneration, and white matter degeneration.

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Summary: Onchocerciasis-associated epilepsy (OAE) is an important neglected public health problem in areas with high ongoing onchocerciasis transmission. The risk that children in such areas develop epilepsy is related to their Onchocerca volvulus microfilarial (mf) load. It is possible that microfilariae enter the brain and, upon dying, cause an inflammatory reaction inducing seizures.

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Comparison of Structural Changes in Nodding Syndrome and Other Epilepsies Associated With Onchocerca volvulus

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Summary: This study aimed to compare structural changes in the brain on MRI between nodding syndrome (NS) and other forms of onchocerciasis-associated epilepsies (OAEs). The results showed that participants with NS had larger ventricular volumes compared with participants with OAE, indicative of increased global cortical atrophy. Severe disability in NS cases correlated with higher degree of atrophy in gray matter and cerebellar volumes.

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Risk Factors for Nodding Syndrome and Other Forms of Epilepsy in Northern Uganda: A Case-Control Study

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Summary: This study found that O. volvulus seropositivity and premature birth are risk factors for developing nodding syndrome and other forms of non-nodding epilepsy. Being born before the migration to internally displaced persons (IDP) camps was a risk factor for developing other forms of non-nodding epilepsy.

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Persons with onchocerciasis-associated epilepsy and nodding seizures have a more severe form of epilepsy with more cognitive impairment and higher levels of Onchocerca volvulus infection

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Neuroinflammation and Not Tauopathy Is a Predominant Pathological Signature of Nodding Syndrome

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