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Trends Parasitol. 2018 Mar;34(3):208-216. doi: 10.1016/ Epub 2017 Dec 26.

Onchocerciasis-Associated Epilepsy, an Additional Reason for Strengthening Onchocerciasis Elimination Programs.

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Global Health Institute, University of Antwerp, Antwerp, Belgium. Electronic address:
Global Health Institute, University of Antwerp, Antwerp, Belgium.


A high prevalence of epilepsy has been observed in onchocerciasis-endemic regions with high onchocerciasis transmission. Recent epidemiological studies suggest that Onchocerca volvulus infection is the trigger causing the seizures, which appear in previously healthy children between the ages of 3 and 18 years. Persons with onchocerciasis-associated epilepsy present with a wide spectrum of seizures, including atonic and myoclonic neck seizures; but also absences and most frequently generalized tonic-clonic seizures. Often individuals present with intellectual disabilities and psychiatric disorders and occasionally with 'Nakalanga' features such as severe stunting with delayed or absent external signs of sexual development. Onchocerciasis-associated epilepsy, because of its importance as a public health problem, is an additional reason for strengthening onchocerciasis elimination programs.


Nakalanga syndrome; autoimmunity; epilepsy; leiomodin-1; nodding syndrome; onchocerciasis

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