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Query: UMLS:C0036572 (seizures)
 80,221 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Epidemiological surveys indicate that the prevalence of epilepsy is higher in developing countries than in industrialized countries. Except for neurocystocercosis due to Taenia solium, little is known about possible underlying causes. This article reports the relationship between epilepsy and onchocerciasis in an Onchocerca volvulus endemic area in West Uganda. Individuals complaining of seizures were identified by means of a population census in 12 villages. Active epilepsy was confirmed in 61 of 4743 inhabitants (crude prevalence rate = 1.3%; age-standardized rate = 1.1%). Distribution of epilepsy in the study area was clustered, ranging from a prevalence of 0.2% to 3.4% in different villages. Age-specific prevalence was highest between 10 and 19 years, with a rate of 3.6% for the study are as a whole, and up to 10.0% in villages of high epilepsy prevalence. The prevalence of onchocerciasis in the 10-19-year-old age group was assessed by skin-snip biopsy and ranged from 15% to 85% in different villages. Epilepsy was significantly more frequent in the three villages with the highest levels of O. volvulus endemicity than in other villages (P < 0.0001). Serological testing for T. solium infection was positive in one and borderline in three of 53 epilepsy patients tested. The significant correlation between epilepsy and onchocerciasis did not change when these four patients were excluded from the analysis. These findings suggest a strong association between epilepsy and onchocerciasis in this area. This could have significant implications for the concept of morbidity due to O. volvulus.
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PMID:The prevalence of epilepsy follows the distribution of onchocerciasis in a west Ugandan focus. 882 57

A door-to-door survey was conducted in 18 villages in Mali with a total of 5,243 inhabitants classified according to the endemicity of onchocerciasis. Each epileptic was matched with two controls. The survey protocol included the following steps in cases and controls: census taking, socioeconomic data, screening for epilepsy, clinical examination, laboratory testing to detect parasites in stools and urine, and snip-test. The crude prevalence of epilepsy was 13.35 per 1,000 (n = 70). Epidemiological study provided a number of valuable demographic insights concerning age at onset, type of seizure activity during seizure and personal and family medical history. A transverse study showed that the prevalence of epilepsy was not significantly higher (p = 9.09) in zones of high endemicity of onchocerciasis (16.1 per 1000) than in zones of low endemicity (10.8 per 1000). Case-control findings showed evidence of onchocerciasis in 22.4 p. 100 of epileptics and 21.7 p. 100 of controls (odds ratio = 1.02 IC 95 p. 100: 0.4-2.19, not significant). Various risk factors including genetic factors and low socio-economic status could explain the trend toward a higher incidence of epilepsy as well as higher morbidity rates in zones of high endemicity of onchocerciasis.
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PMID:[Onchocerciasis and epilepsy. Epidemiological survey in Mali]. 1110 Apr 41

When compared to that of industralised countries, the prevalence of epilepsy in developing countries has generally been found to be higher and in some areas extremely high rates of up to 57 cases per 1000 inhabitants have been reported. The reasons for this difference are still widely unknown and detailed epidemiological as well as clinical data are scarce, especially from rural Africa. The present study was conducted in western Uganda, in an area of high epilepsy prevalence, known to be endemic for onchocerciasis. The seizures of all 91 epilepsy patients diagnosed in this area over the period of two years were classified according to the criteria of the International League against Epilepsy. Based on seizure description alone, the predominant seizure was classified as generalised in 57 patients (63%), as partial in 22 (24%) and unclassified in 12 (13%). An EEG record was analysed in 55 out of 91 patients, showing focal epileptiform activity (EA) in 12, multifocal EA in 9 and primarily generalised EA in 6 patients. When in addition to clinical information, the EEG results in the 27 patients with EA were taken in consideration for seizure classification, the proportion of partial seizures increased to 78% (n = 21); inversely the proportion of generalised seizures fell to 22% (n = 6). The predominance of partial seizures would be compatible with a localised brain lesion as a frequent cause for epileptic seizures in the study area. The findings further corroborate recent observations from several African countries of an association between epilepsy and onchocerciasis.
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PMID:Clinical and electro-clinical classification of epileptic seizure in west Uganda. 1120 26

In November 2010, the Ministry of Health of the proposed nation of South Sudan requested CDC assistance in investigating a recent increase and geographic clustering of an illness resulting in head nodding and seizures. The outbreak was suspected to be nodding syndrome, an unexplained neurologic condition characterized by episodes of repetitive dropping forward of the head, often accompanied by other seizure-like activity, such as convulsions or staring spells. The condition predominantly affects children aged 5-15 years and has been reported in South Sudan from the states of Western and Central Equatoria and in Northern Uganda and southern Tanzania. Because of visa and security concerns, CDC investigators did not travel to South Sudan until May 2011. On arrival, a case-control study was conducted that included collecting exposure information and biologic specimens to assess the association of nodding syndrome with suspected risk factors. A total of 38 matched case-control pairs were enrolled from two different communities: Maridi and Witto. Overall, current infection with Onchocerca volvulus diagnosed by skin snip was more prevalent among the 38 case-patients (76.3%) than the controls (47.4%) (matched odds ratio [mOR] = 3.2). This difference was driven by the 25 pairs in Maridi (88.0% among case-patients, 44.0% among controls, mOR=9.3); among the 13 pairs in Witto, no significant association with onchocerciasis (known as river blindness) was observed. Although onchocerciasis was more prevalent among case-patients, whether infection preceded or followed nodding syndrome onset was unknown. Priorities for nodding syndrome investigations include improving surveillance to monitor the number of cases and their geographic distribution and continued work to determine the etiology of the syndrome.
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PMID:Nodding syndrome - South Sudan, 2011. 2227 59

An epidemic illness characterized by head nodding associated with onchocerciasis has been described in eastern Africa since the early 1960s; we summarize published reports and recent studies. Onset of nodding occurs in previously healthy 5-15-year-old children and is often triggered by eating or cold temperatures and accompanied by cognitive impairment. Its incidence has increased in Uganda and South Sudan over the past 10 years. Four case-control studies identified modest and inconsistent associations. There were nonspecific lesions seen by magnetic resonance imaging, no cerebrospinal fluid inflammation, and markedly abnormal electroencephalography results. Nodding episodes are atonic seizures. Testing has failed to demonstrate associations with trypanosomiasis, cysticercosis, loiasis, lymphatic filariasis, cerebral malaria, measles, prion disease, or novel pathogens; or deficiencies of folate, cobalamin, pyridoxine, retinol, or zinc; or toxicity from mercury, copper, or homocysteine. There is a consistent enigmatic association with onchocerciasis detected by skin snip or serologic analysis. Nodding syndrome is an unexplained epidemic epilepsy.
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PMID:Nodding syndrome. 2396 48

Nodding syndrome (NS) is a poorly understood condition, which was delineated in 2008 as a new epilepsy syndrome. So far, confirmed cases of NS have been observed in three circumscribed African areas: southern Tanzania, southern Sudan, and northern Uganda. Case-control studies have provided evidence of an association between NS and infection with Onchocerca volvulus, but the causation of NS is still not fully clarified. We report a case of a 15-year old boy with head nodding seizures and other characteristic features of NS from an onchocerciasis endemic area in western Uganda, with no contiguity to the hitherto known areas. We suggest that the existence of NS should be systematically investigated in other areas.
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PMID:Nodding syndrome, western Uganda, 1994. 2591 8

High prevalence of nodding syndrome (NS) and other types of epileptic seizures have been reported in many onchocerciasis endemic regions in Africa for decades. To improve quality of life of affected patients and families, there is an urgent need to unravel the relationship between these epileptic disorders and onchocerciasis, and to design treatment and prevention strategies.
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PMID:Nodding Syndrome in Onchocerciasis Endemic Areas. 2728 72

Nodding Syndrome (NS) is a childhood neurological disorder characterized by atonic seizures, cognitive decline, school dropout, muscle weakness, thermal dysfunction, wasting and stunted growth. There are recent published information suggesting associations between Nodding Syndrome (NS) with cerebrospinal fluid (CSF) VGKC antibodies and serum leiomidin-1 antibody cross reacting with Onchocerca Volvulus (OV). These findings suggest a neuro-inflammatory cause of NS and they are important findings in the search for the cause of Nodding Syndrome. These observations perhaps provide further, the unique explanation for the association between Nodding Syndrome and Onchocerca Volvulus. Many clinical and epidemiological studies had shown a significant correlation between NS and infestation with a nematode, Onchocerca volvulus which causes a disease, Onchocerciasis, some of which when left untreated can develop visual defect ("River Blindness"). While these studies conducted in Northern Uganda and Southern Sudan indicate a statistically significant association with (OV infection (using positive skin snips), we observe that (OV is generally endemic in many parts of Sub Saharan Africa and Latin America and that to date, no NS cases have been recorded in those regions. This letter to the Editor is to provide additional information on the current view about the relationship between Nodding Syndrome and Onchocerca Volvulus as seen in Northern Uganda.
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PMID:Nodding syndrome (NS) and Onchocerca Volvulus (OV) in Northern Uganda. 2913 47

A high prevalence of epilepsy has been observed in onchocerciasis-endemic regions with high onchocerciasis transmission. Recent epidemiological studies suggest that Onchocerca volvulus infection is the trigger causing the seizures, which appear in previously healthy children between the ages of 3 and 18 years. Persons with onchocerciasis-associated epilepsy present with a wide spectrum of seizures, including atonic and myoclonic neck seizures; but also absences and most frequently generalized tonic-clonic seizures. Often individuals present with intellectual disabilities and psychiatric disorders and occasionally with 'Nakalanga' features such as severe stunting with delayed or absent external signs of sexual development. Onchocerciasis-associated epilepsy, because of its importance as a public health problem, is an additional reason for strengthening onchocerciasis elimination programs.
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PMID:Onchocerciasis-Associated Epilepsy, an Additional Reason for Strengthening Onchocerciasis Elimination Programs. 2928 80

A high prevalence of epilepsy is reported in many onchocerciasis-endemic regions. In this paper we discuss recent epidemiological and clinical aspects as well as public health implications of onchocerciasis-associated epilepsy (OAE) and propose a strategy to reduce the burden of disease. OAE probably presents in a variety of clinical manifestations, including the nodding syndrome and the Nakalanga syndrome. The most common clinical presentation, however, is generalized (primarily tonic-clonic) seizures. A characteristic of OAE is the onset of seizures between the ages of 3 and 18 years and clustering in certain families and villages close to rapid-flowing black-fly-infested rivers. A strategy combining active surveillance for epilepsy with early treatment with antiepileptic drugs and prevention of onchocerciasis by increasing the geographical and therapeutic coverage of community-directed treatment with ivermectin (CDTi) may considerably decrease the burden of disease.
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PMID:Onchocerciasis-associated epilepsy: From recent epidemiological and clinical findings to policy implications. 2958 43


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