| 43 |
2008 |
The head nodding syndrome - clinical classification and possible causes of a new epilepsy disorder |
Tanzania |
N/A |
Cohort |
62 |
- |
90.3% had at at least one relative with epilepsy. Association with OV: 31/51 SS and 12/20 PCRs were OV+. CSF PCR negative (0/48). |
Neurology |
| 26 |
2012 |
Nodding syndrome - South Sudan |
South Sudan |
2010 |
Case-control |
38 |
38 |
NS associated with OV+ SS. Total study figues included Maridi and Witto communities. Among the 25 Maridi matched pairs, 88% of cases vs 44% of controls were OV+. No significant OV association between the 13 Witto pairs. |
Morbidity and Mortality Weekly Report |
| 7 |
2012 |
Clinical and epidemiologic characteristics of nodding syndrome in Mundri County, southern Sudan |
South Sudan |
2001-02 |
Case-control |
82 |
81 |
No association with MV: 2/13 NS patients had a history of MV vs 11/19 controls. Association with OV: 76/82 NS patients had OV+ SS vs 39/81 controls. HN triggered by food (73% of 39 cases). Association with serena (sorghum): OR=6.22; P=0.049. Association with MP: OR=3.22; P= 0.05. |
African Health Sciences |
| 6 |
2013 |
An epidemiologic investigation of potential risk factors for nodding syndrome in Kitgum District, Uganda |
Uganda |
2009 |
Case-control |
49 |
49 |
No association with MV or sorghum. Serological association with OV, exposure to munitions (AOR=13.9 [1.4-135.5]), consumption of crushed cassava roots (AOR=5.4 [1.3-22.1]), visual hallucinations (AOR=13.6 [1.5-121.7]) and vitamin B6 deficiency (84% cases, 75% controls). Matched seological AORs for Ov16 and OvFAR/MSA were 3.16 (0.84-11.89) and 20.80 (1.37-316.24) respectively. |
PLoS One |
| 29 |
2013 |
Nodding syndrome in Ugandan children-clinical features, brain imaging and complications: a case series |
Uganda |
2012 |
Case series |
22 |
- |
MRI and EEG findings described. 12/22 NS patients had psychiatric morbidities. A 57% reduction in total seizure burden was achieved with sodium valproate. |
BMJ Open |
| 33 |
2013 |
Nodding syndrome (NS) in Northern Uganda: a probable metabolic disorder |
Uganda |
2012 |
Case-control |
101 |
101 |
NS associated with malnutrition, OV and a high anion gap. |
British Journal of Medicine and Medical Research |
| 38 |
2013 |
Clinical, neurological, and electrophysiological features of nodding syndrome in Kitgum, Uganda: an observational case series |
Uganda |
2009 |
Case series |
23 |
- |
MRI, CSF and EEG findings described. No evidence of inflammation found. |
Lancet Neurology |
| 2 |
2013 |
Nodding syndrome: origins and natural history of a longstanding epileptic disorder in sub-Saharan Africa |
Tanzania |
1960-71 |
Retrospective |
150 |
- |
Historical evidence for probable NS cases with onset between 1934 and 1962. |
African Health Sciences |
| 40 |
2013 |
Nodding syndrome in Mundri county, South Sudan: environmental, nutritional and infectious factors |
South Sudan |
2001/2012 |
Case-control |
|
|
Analysis of data from Tumwine and colleagues 2012. Adds no association with cassava consumption. |
African Health Sciences |
| 44 |
2013 |
MRI findings in people with epilepsy and nodding syndrome in an area endemic for onchocerciasis: an observational study |
Tanzania |
N/A |
Cohort |
12 |
20 |
MRI findings described. Cerebral pathology associated with OV (SS/PCR). Control group was OCE patients. |
African Health Sciences |
| 27 |
2014 |
Nodding syndrome in Tanzania may not be associated with circulating anti-NMDA- and anti-VGKC receptor antibodies or decreased pyridoxal phosphate serum levels-a pilot study |
Tanzania |
N/A |
Case-control |
22 |
8 |
Controls=7 healthy, 1 OCE. No evidence for NMDA or VKGC autoantibodies. No association with pyridoxal-phosphate serum levels. |
African Health Sciences |
| 31 |
2014 |
Detection of auto-antibodies to leiomodin-1 in patients with nodding syndrome |
N/A |
N/A |
Case-control |
19 |
19 |
Anti-LM-1 Ig was detected in the serum of 11/19 NS patients and 5/19 controls. Anti-LM-1 identified in the CSF of an unreported number of NS patients, shown to be neurotoxic in vitro and cross-react with OV tropomyosin. LM-1 expression shown in CNS regions comparable with reported MRI findings. |
Journal of Neuroimmunology |
| 34 |
2014 |
High anion gap metabolic acidosis among children with nodding syndrome (NS) in Northern Uganda: case series |
Uganda |
2012 |
Case series |
10 |
- |
Of the 10 probable NS cases all had hypocalcaemia, raised bicarbonate and a high anion gap suggestive of metabolic acidosis. |
British Journal of Medicine and Medical Research |
| 35 |
2014 |
Nodding syndrome in Kitgum District, Uganda: association with conflict and internal displacement |
N/A |
N/A |
Retrospective |
N/A |
N/A |
Retrospective analyses suggested that conflict and movement of people into IDP camps were associated with rises in NS 5-6 and 7 years later respectively. |
BMJ Open |
| 37 |
2014 |
Physical growth, puberty and hormones in adolescents with nodding syndrome; a pilot study |
Uganda |
N/A |
Cross-sectional |
10 |
- |
Endocrinological analysis suggestive of pituitary growth and gonadal hormone axis dysfunction. 5/8 NS patients had stunting, 8/8 had a normal serum GH level, but 3/8 had low IGF1/IGFBP3. Thyroid, adrenal, parathyroid, prolactin levels were normal. |
BMC Research Notes |
| 32 |
2015 |
Nodding episodes and high anion gap in a 13-year-old child with nodding syndrome: a case report |
Uganda |
N/A |
Case report |
1 |
- |
Report of a 13-year-old male with probable NS and pyomystitis, as reported in Kitara 2013. Adds temporal association between an elevated anion gap and the presence of seizures. |
British Journal of Medicine and Medical Research |
| 39 |
2015 |
Nodding syndrome: an epileptic disorder restricted to Africa? |
N/A |
2014 |
Case-control |
50 |
50 |
Much data available in Spencer and colleagues 2016. This adds that mycotoxin analysis of plasma and urine found no difference between cases and controls. |
Journal of the Neurological Sciences |
| 30 |
2016 |
Is nodding syndrome an Onchocerca volvulus-induced neuroinflammatory disorder? Uganda's story of research in understanding the disease |
N/A |
2013 |
Case-control |
31 |
11 |
Review, included as it contains data not published elsewhere. 15/31 NS patients vs 1/11 controls were anti-VGKC Ig positive. |
International Journal of Infectious Diseases |
| 36 |
2016 |
Reduced plasma concentrations of vitamin B6 and increased plasma concentrations of the neurotoxin 3-hydroxykynurenine are associated with nodding syndrome: a case control study in Gulu and Amuru districts, Northern Uganda |
Uganda |
2013 |
Case-control |
66 |
73 |
Low plasma vitamin B6 (AOR=7.22, P=0.001), raised 3-HK (AOR=4.50, P=0.0130), child being cared for by mother only (AOR=5.43, P=0.011), child being cared for by guardian (AOR=5.90, P=0.019) and consumption of relief food at weaning (AOR= 4.05, P=0.021) were associated with NS. |
Pan African Medical Journal |
| 42 |
2016 |
Nodding syndrome: 2015 international conference report and Gulu Accord |
N/A |
N/A |
Mixed |
N/A |
N/A |
Report from the 2015 international conference on NS. Results presented, not found elsewhere, include a case-control study (n=39 and 41 respectively) that associated low houshold income and not purifying water with NS. A cross-sectional study investigating the psychiatric and psychological features of 225 Ugandan NS patients, the majority of cases (51.6% male, 48.4% female) started HN in IDP camps between 2005-10. Psychiatric disorders included major episodic depression (25.3%), PTSD (16.4%), GAD (30.7%) and PDD (4%). |
eNeurologicalSci |
| 41 |
2016 |
Environmental, dietary and case-control study of nodding syndrome in Uganda: a post-measles brain disorder triggered by malnutrition? |
Uganda |
2014 |
Case-control |
50 |
50 |
Onset of NS peaked in 2003 and 2008, primarily in April and June. Eating emergency food (OR=4.0 [1.3-17.6], p=0.016), maize (OR=4.00 [1.0-26.5]), mouldy maize (OR=4.33 [1.4-18.9], p=0.009) and a history of MV (OR=6.00 [1.03-113], p=0.047) were associated with NS. |
Journal of the Neurological Sciences |
| 25 |
2017 |
Metabolic analysis of children affected with nodding syndrome in north Uganda: A pilot study |
Uganda |
2014 |
Cohort |
48 |
- |
Much data available in Denis and colleagues 2017. This study adds clinical biochemistry findings. 37/47 had low biotinidase. Mean BMI was 16.9. Mean acetyl carnitine level was low. Proprionyl carnitine and butyryl carnitine levels were elevated. |
Developmental Medicine and Child Neurology |
| 17 |
2017 |
Is there a line between internal displacement; environmental and dietary factors in the onset of nodding syndrome in northern Uganda? A clinical observational study design |
Uganda |
2014 |
Cohort |
48 |
- |
Duration of stay in IDP camps and being in a family in which the firstborn had NS were strongly associated with NS. |
World Journal of Pharmaceutical and Medical Research |
| 28 |
2017 |
Nodding syndrome: multimycotoxin case-control study in Northern Uganda |
Uganda |
2014 |
Case-control |
50 |
50 |
Analysis of plasma and urine samples from Spencer and colleagues 2016. Mycotoxins were detected in 14% and 12% of NS and control cases respectively; concluded the mycotoxin burden was similar. |
Annals of Neurology |
| 8 |
2017 |
Nodding syndrome may be an autoimmune reaction to the parasitic worm Onchocerca volvulus |
N/A |
N/A |
Case-control |
55 |
55 |
Added data for a further 36 cases and controls to the data from Johnson 2014, giving 55 matched pairs. Of the NS cases, 80% were OV+ and 52.7% were anti-LM-1 Ig+. Of the controls, 45.5% were OV+ and 30.9% were anti-LM-1 Ig+. The finding that anti-LM-1 Ig to be neurotoxic in vitro and cross-react with OV tropomyosin was confirmed. LM-1 expression shown in CNS regions comparable with reported MRI findings. 8/16 CSF samples from NS patients were anti-LM-1 Ig+, compared to 0/8 North American controls. |
Science Translational Medicine |
| 16 |
2018 |
Could nodding syndrome in Northern Uganda be a form of autism |
Uganda |
2014 |
Cohort |
? |
? |
Much data available in Denis and colleagues 2017. This study conjectures that NS may be akin to ASD. |
Pan African Medical Journal |