Department of Neurology, Technical University of Munich, Munich, Germany.
Epilepsia. 2014 Jan;55(1):86-93. doi: 10.1111/epi.12483. Epub 2013 Dec 20.
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.
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.
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.
This follow-up study confirms that HN represents an epilepsy disorder, possibly of the atypical absence type with dynamic development over time.
点头综合征（NS）是一种新的撒哈拉以南非洲地区的癫痫疾病，最近才被分类。2005 年在坦桑尼亚南部进行的一项研究中，对 62 例 NS 患者进行了详细分析。本研究为后续调查，旨在评估 NS 随时间的进展，并获得连续的脑电图（EEG）数据。
在 62 例 NS 患者中，有 53 例（85.5%）目前正在接受某种形式的抗癫痫治疗，他们能够在 2009 年用标准化问卷进行重新评估。其中一部分患者（25/53）接受了 EEG 检查。
在 2005 年仅有“头部点头（HN）”的患者中，23 例中有 10 例（43.5%）仍保持相同的诊断，而 23 例中有 5 例（21.7%）发展为“HN 加”（即 HN 和全面强直阵挛发作）。6 例患者（26.1%）出现 HN 以外的其他发作，2 例患者（8.7%）完全康复。在 2005 年的“HN 加”组中，30 例患者中有 9 例（30.0%）仍为“HN 加”，15 例患者（50.0%）出现 HN 以外的其他发作。4 例患者（13.3%）恢复为“HN 仅”，2 例患者（6.7%）停止所有发作。在 25 例患者中，有 11 例（44.0%）的脑电图（EEG）显示为全面性减慢。在这 11 例异常 EEG 研究中，有 6 例（54.6%）进一步显示出全面性癫痫样放电：（1）2 例患者出现全面性 2.5Hz 棘慢波发作的癫痫样脑电图模式；（2）4 例患者出现 1.5-2Hz 棘慢波的发作性爆发。
本随访研究证实 HN 代表一种癫痫疾病，可能为动态发展的非典型失神发作类型。
