doi: 10.1371/journal.pntd.0007344. van der Waals FW, Goudsmit J, Gajdusek DC. All authors read and approved the final manuscript and agreed on its submission. This guideline was adopted as the standard reference for use by NS-affected countries during the first international scientific conference on NS in Kampala, Uganda in August 2012.37 The recommended treatments are based on symptoms and rehabilitation measures to ensure optimal functioning by the affected children.36 A review of over 500 patients in more than ten NS treatment health facilities in northern Uganda revealed reasonable symptoms control with use of anticonvulsants, nutritional support, psychotropic medications, and physical therapies based on this treatment guideline.34 Since the observation that seizures in NS respond appropriately to anticonvulsants and because there are no known causes to target, the objective of treatment in NS has been to relieve symptoms, offer primary and secondary prevention for disability, and rehabilitation to improve function.34,36 The current anticonvulsant of choice in treatment of NS is sodium valproate (Valparin 200mg, Torrent Pharmaceutical Ltd., Mehsana, India). Nodding syndrome is an unexplained epidemic epilepsy. Wasswa H. Ugandan authorities deal with a mysterious ailment that leaves people nodding continuously. No treatments have proven effective in reversing the course of the disorder, and cure remains a distant goal. CDC twenty four seven. Would you like email updates of new search results?  Sub-clinical seizures have been identified in electroencephalograms, and MRI scans have shown brain atrophy and damage to the hippocampus and glia cells. Dr Thomas Unnasch, Amos Deogratius Mwaka,1 Jerome Roy Semakula,2 Catherine Abbo,3 Richard Idro4 1Department of Medicine, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda; 2Infectious Diseases Institute, Makerere University College of Health Sciences, Kampala, Uganda; 3Department of Psychiatry, College of Health Sciences, Makerere University, Kampala, Uganda; 4Department of Pediatrics and Child Health, College of Health Sciences, Makerere University, Kampala, Uganda Abstract: Nodding syndrome is an enigmatic neuropsychiatric and epileptiform disorder associated with psychomotor, mental, and physical growth retardation. 2008;49(9):14911503. Nodding syndrome is 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. Afr Health Sci. Specific treatments for NS are urgently needed to reverse the miserable health states of the NS-affected children. 2017;2(2):145152. 1965;41(1):5786. Careers. It is thought that the spirits attack children aged 318 years for two reasons; the child-soldiers who were forced to kill them were about that age, and second, the children in this age group who are returning home from the camps played with the unburied remains/bones of the innocently slayed persons.17,22,23 The vengeful spirits therefore target the children in this age group. 2013;17(3):e149e152. Sodium valproate is also active against some behavioral difficulties like aggression and impulsive behavior. Current treatments for NS include use of anticonvulsants, especially sodium valproate for seizure control, and behavioral modifications including agitation and aggression in affected children. , It is currently not known what causes the disease, but it is believed to be connected to infestations of the parasitic worm Onchocerca volvulus, which is prevalent in all outbreak areas, and a possible explanation involves the formation of antibodies against parasite antigen that are cross-reactive to leiomodin-1 in the hippocampus. Kleinman A. In 2004, most children with nodding disease lived close to the Yei River, a hotbed for river blindness, and 93.7% of those with nodding disease were found to harbour the parasite a far higher percentage than in children without the disease.
The culture of any given society determines how they react to and cope with illnesses.14,15 Researchers have used the Kleinman illness explanatory model for understanding new illnesses and their impacts on society to investigate the perceptions and beliefs of the NS-affected communities. Winkler AS, Friedrich K, Meindl M, et al. Nodding episodes are atonic seizures.
Is the glass half full or half empty? Image shows prominent cortical atrophy.  Nutritional deficiencies may also be present. The site is secure. The disease is named for the characteristic, pathological nodding seizure, which often begins when the children begin to eat, or sometimes when they feel cold. eCollection 2019 Jun.
HHS Vulnerability Disclosure, Help See this image and copyright information in PMC. eCollection 2021 Oct. Ogwang R, Ningwa A, Akun P, Bangirana P, Anguzu R, Mazumder R, Salamon N, Henning OJ, Newton CR, Abbo C, Mwaka AD, Marsh K, Idro R. Front Neurol. Knowledge of the causative agents and/or pathogenesis of NS is necessary for development of specific drug therapy that could lead to cure of NS as well as inform strategies for prevention. Studies have revealed a consistent association of the cause of NS with war, internal displacement, and food shortages among communities in Northern Uganda.1618 Majority of community members in the affected regions believe that NS resulted from some conditions related to the civil war and the internally displaced person (IDP) camps where the population in northern Uganda and South Sudan were forced to live during the insurgency as a way of protecting them from rebel brutality. 2014;27:7477.
Associations & Partners , US Centers for Disease Control and Prevention.
2016;11(7):e0159549. Its incidence has increased in Uganda and South Sudan over the past 10 years. Kleinman A. Concepts and a model for the comparison of medical systems as cultural systems. Sodium valproate is administered, starting with a dose of 10 mg/kg/d in two divided doses and then increasing the dose by 5 mg/kg/d until seizure control is achieved or the maximum dose of 40 mg/kg/d in children is reached.