Southern Sudan Struggles with Outbreak of Nodding Disease

July 20, 2011

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By Jose Merino, MD, FAAN
Science Editor, AAN.com

Nodding disease is a rare epilepsy disorder of unknown etiology first described in Tanzania. An outbreak in Southern Sudan is challenging the health resources of this newly independent country. An interesting article in Nature highlights how the efforts of the international health community, including the WHO and the CDC, are needed to fight this condition and give the new country some relief.

Nodding disease afflicts children between 5 and 15 years old. In this disorder, seizures produce a lapse in neck muscle tone that causes the head to fall forward. Other seizure types may accompany these "head nodding seizures." Many patients become malnourished because of difficulty eating, and may be stigmatized because of fear of contagion. The etiology is uncertain. There is a higher prevalence of nodding in children with serum evidence of infection with Onchocerca volvulus, the parasite that causes river blindness, but a recent study in Tanzania failed to find evidence of antibodies to the parasite in the CSF, suggesting that an autoimmune process may cause the disorder. Nutritional factors have also been implicated.