Tumwine J K, Vandemaele K, Chungong S, Richer M, Anker M, Ayana Y, Opoka M L, Klaucke D N, Quarello A, Spencer P S
Department of Paediatrics and Child Health Makerere University, Kampala, Uganda.
Afr Health Sci. 2012 Sep;12(3):242-8. doi: 10.4314/ahs.v12i3.1.
Nodding syndrome (repetitive nodding and progressive generalized seizures) is assuming epidemic proportions in South Sudan, Tanzania and Uganda.
To describe clinical and epidemiological features of nodding syndrome in southern Sudan based on preliminary investigations conducted in 2001 and 2002.
Household surveys, clinical, electrophysiological (EEG) assessments, informant interviews and case-control studies were conducted in the town of Lui and the village of Amadi in southern Sudan.
Nodding syndrome is characterized by involuntary repetitive nodding of the head, progressing to generalized seizures; mental and physical deterioration. The EEGs were consistent with progressive epileptic encephalopathy. Prevalence of Nodding syndrome in Lui and Amadi was 2.3% and 6.7% respectively. All case control studies showed a positive association between cases and Onchocerca volvulus. A history of measles was negatively associated with being a case: 2/13 of cases and 11/19 of controls had had measles: odds ratio 0.13 (95% CI 0.02, 0.76). Environmental assessment did not reveal any naturally occurring or manmade neurotoxic factors to explain Nodding Syndrome, although fungal contamination of food could not be ruled out.
Nodding Syndrome was strongly associated with Onchocerca volvulus. There was no evidence to suggest an environmental pollutant, chemical agent, or other toxic factor.
点头综合征（重复性点头和进行性全身性癫痫发作）在南苏丹、坦桑尼亚和乌干达正呈流行态势。
根据2001年和2002年进行的初步调查，描述苏丹南部点头综合征的临床和流行病学特征。
在苏丹南部的卢伊镇和阿马迪村开展了家庭调查、临床、电生理（脑电图）评估、信息提供者访谈和病例对照研究。
点头综合征的特征为头部不自主重复性点头，进而发展为全身性癫痫发作；智力和身体机能衰退。脑电图结果与进行性癫痫性脑病相符。卢伊和阿马迪的点头综合征患病率分别为2.3%和6.7%。所有病例对照研究均显示病例与盘尾丝虫之间存在正相关。麻疹病史与患病呈负相关：病例组中有2/13曾患麻疹，对照组中有11/19曾患麻疹：比值比为0.13（95%可信区间为0.02，0.76）。环境评估未发现任何天然或人为的神经毒性因素可解释点头综合征，不过食物受真菌污染的情况无法排除。
点头综合征与盘尾丝虫密切相关。没有证据表明存在环境污染物、化学制剂或其他有毒因素。
