A longitudinal study on nodding syndrome—a new African epilepsy disorder. Issue 1 (20th December 2013)

• Record Type: Journal Article
• Authors: Winkler, Andrea S.; Wallner, Bernd; Friedrich, Katrin; Pfausler, Bettina; Unterberger, Iris; Matuja, William; Jilek‐Aall, Luise; Schmutzhard, Erich
• Is Part Of: Epilepsia. Volume 55:Issue 1(2014:Jan.)
• Page Start: 86
• Page End: 93
• Publication Date: 2013-12-20
• Subjects: Epilepsy -- Periodicals; 616.853
• DOI: 10.1111/epi.12483
• Languages: English
• ISSNs: 0013-9580

Abstract

<abstract abstract-type="main" id="epi12483-abs-0001"> <title>Summary</title> <sec id="epi12483-sec-0001" sec-type="section"> <title>Objectives</title> <p>Nodding syndrome (NS), a new epilepsy disorder of sub‐Saharan Africa, has only recently been classified. In a study conducted in southern Tanzania in 2005, 62 patients with NS were analyzed in great detail. The present study, a follow‐up investigation, was conducted to evaluate the progression of NS over time and to obtain serial electroencephalography (EEG) data.</p> </sec> <sec id="epi12483-sec-0002" sec-type="section"> <title>Methods</title> <p>Of the 62 NS patients, 53 (85.5%), the majority of whom were currently on some form of antiepileptic treatment, could be reevaluated in 2009 with a standardized questionnaire. A subset of these patients (25/53) underwent EEG investigation.</p> </sec> <sec id="epi12483-sec-0003" sec-type="section"> <title>Results</title> <p>In patients with "head nodding (HN) only" in 2005, 10 (43.5%) of 23 remained with the same diagnosis, whereas 5 (21.7%) of 23 had developed "HN plus" (i.e., HN and generalized tonic–clonic seizures). Six patients (26.1%) had seizures other than HN only, and two patients (8.7%) had fully recovered. In the "HN plus" group of 2005, 9 (30.0%) of 30 patients remained "HN plus, " and 15 patients (50.0%) had seizures other than HN only. Four patients (13.3%) reverted to "HN only, " and two patients (6.7%) stopped all seizures. In 11 (44.0%) of 25 patients, electroencephalography (EEG) showed generalized slowing. Six (54.6%) of these 11 abnormal EEG studies further showed generalized epileptiform discharges: (1) ictal electroencephalographic pattern with generalized 2.5 Hz spike and waves in two patients and (2) interictal bursts of 1.5–2 Hz spike and waves in four patients.</p> </sec> <sec id="epi12483-sec-0004" sec-type="section"> <title>Significance</title> <p>This follow‐up study confirms that HN represents an epilepsy disorder, possibly of the atypical absence type with dynamic development over time.</p> </sec> </abstract>