Volume 19, Number 9—September 2013
|Location, author, date, (reference)||No. patients, case definition||Clinical findings||EEG findings||CSF findings||Neuroimaging findings|
|Sudan, Tumwine et al., 2001 (2)||39 with episodes of repetitive head nodding several times a day||Neurologic examination results largely normal for 32 patients, with exception of mental retardation||39 cases evaluated; seizures recorded in 6; disease progression correlated with diffuse slowing and delta–theta activity||16 CSF specimens negative for Onchocerca spp. by PCR||ND|
|Tanzania, Winkler etal., 2008 (9)||62 with a repetitive short loss of neck muscle tone resulting in nodding of the head||Neurologic examination results for 12 patients largely unremarkable; 2 with upper motor neuron findings||6 of 10 with abnormal EEG results, including intermittent generalized slowing and sharp wave activity||48 CSF specimens; 3 with increased lymphocyte counts; protein and glucose levels within reference range for all||8 of 12 brain MRIs showing abnormalities, including hippocampal abnormalities (3), gliotic lesions (3), or both (2)|
|Uganda, Sejvar et al., 2010 (7)||23 with head nodding in previously normal child, with ≥1 other neurodevelopmental abnormality||Neurologic examination results for 23 patients largely unremarkable; 2 with focal findings||10 of 12 with abnormal EEG results, including generalized slowing and runs of spike activity; 2 nodding episodes recorded, demonstrating atonic seizure||16 CSF specimens; all grossly clear, with glucose and protein levels within reference ranges||4 of 5 brain MRIs showing varying degrees of cortical and cerebellar atrophy disproportionate to age; no focal/white matter lesions|
|South Sudan, Bunga, 2011 (unpub. data)||25 with head nodding in previously normal child, with ≥1 other neurodevelopmental abnormality||Neurologic examination for 25 nonfocal patients||ND||ND||ND|
*EEG, electroencephalography; CSF, cerebrospinal fluid; ND, not done; MRI, magnetic resonance image.