Raper AB , Ladkin RG , 1950. Endemic dwarfism in Uganda. East Afr Med J 27: 339–359.
Marshall AJ , Cherry JK , 1961. Endocrine dysfunction in a Nakalanga dwarf. Trans R Soc Trop Med Hyg 55: 188–191.
Jelliffe DB , Jones PR , Stroud CE , 1962. Nakalanga notes on the endemic dwarfism of Uganda. Trop Geogr Med 14: 97–104.
Bagenda R , Batwala J , Stanfield JP , 1964. Banakalanga: a domiciliary study into definitions and attitudes. East Afr Med J 41: 324–332.
Leonard PJ , Stanfield JP , 1965. Some biochemical observations in the Nakalanga. East Afr Med J 42: 692–694.
Casis Sacre G , 1938. El sindrome epileptico y sus relaciones con la Oncocercosis. Boletin de Salubridad e Higiene (Mexico) 1: 11–31.
Kipp W , Burnham G , Bamuhiiga J , Leichsenring M , 1996. The nakalanga syndrome in Kabarole district, western Uganda. Am J Trop Med Hyg 54: 80–83.
Kaiser C , Kipp W , Asaba G , Mugisa C , Kabagambe G , Rating D , Leichsenring L , 1996. The prevalence of epilepsy follows the distribution of onchocerciasis in a west Ugandan focus. Bull World Health Organ 74: 361–367.
Kaiser C , Asaba G , Kasoro S , Rubaale T , Kabagambe G , Mbabazi M , 2007. Mortality from epilepsy in an onchocerciasis-endemic area in west Uganda. Trans R Soc Trop Med Hyg 101: 48–55.
Winkler AS et al. 2008. The head nodding syndrome - clinical classification and possible causes. Epilepsia 49: 2008–2015.
Föger K , Gora-Stahlberg G , Sejvar J , Ovuga E , Jilek-Aall L , Schmutzhard E , Kaiser C , Winkler AS , 2017. Nakalanga syndrome: clinical characteristics, potential causes, and its relationship with recently described nodding syndrome. PLoS Negl Trop Dis 11: e0005201.
Spencer PS , Mazumder R , Palmer VS , Pollanen MS , 2019. Nodding syndrome phenotypes. Rev Neurol 175: 679–685.
Kaiser C , Asaba G , Rubaale T , Tukesiga E , Kipp W , 2018. Onchocerciasis-associated epilepsy with head nodding seizures—nodding syndrome: a case series of 15 patients from western Uganda, 1994. Am J Trop Med Hyg 99: 1211–1218.
Commission on Classification and Terminology of the International League against Epilepsy , 1981. Proposal for revised clinical and electroencephalographical classification of epileptic seizures. Epilepsia 22: 489–501.
Kaiser C , Benninger C , Asaba G , Mugisa C , Kabagambe G , Kipp W , Rating D , 2000. Clinical and electro-clinical classification of epileptic seizures in west Uganda. Bull Soc Pathol Exot 93: 255–259.
Kaiser C , Asaba G , Mugisa C , Kipp W , Kasoro S , Rubaale T , Kabagambe G , 1998. Anti-epileptic drug treatment in rural Africa: involving the community. Trop Doct 28: 73–77.
Kaiser C , 1998. Introducing Anti-Epileptic Treatment into Primary Health Care: A Case Study in an Area of High Epilepsy Prevalence in Kabarole District, West Uganda. Thesis, Master of Science in Community Health and Health Management in Developing Countries. Heidelberg, Germany: Institute of Tropical Hygiene and Public Health, University of Heidelberg.
Gumisiriza N , Kaiser C , Asaba G , Onen H , Mubiru F , Kisembo D , Siewe Fodjo JN , Colebunders R , 2020. Changes in epilepsy burden after onchocerciasis elimination in a hyperendemic focus of western Uganda: a comparison of two population-based, cross-sectional studies. Lancet Infect Dis 20: 1315–1323.
CDC , 2012. CDC Responds to Nodding Disease (Video). Available at: https://www.cdc.gov/globalhealth/noddingsyndrome/default.htm or https://www.youtube.com/watch?v=LwOUzE03xm0. Accessed March 14, 2020.
Cable News Network (CNN) , 2011. Nodding Disease Baffles Experts (Video). Available at: https://www.who.int/onchocerciasis/symptoms/nodding_syndrome/en/or https://www.youtube.com/watch?v=5S7QLocaS0M&feature=youtu.be. Accessed March 14, 2020.
Van Bemmel K , Aalten E , 2014. Nodding Syndrome, an Illness-In-The-Making. Documentary Based on Fieldwork in Northern Uganda (Video). Available at: https://vimeo.com/noddingsyndrome. Accessed March 14, 2020.
World Health Organization , 2012. International Scientific Meeting on Nodding Syndrome, Kampala, Uganda. Available at: http://www.who.int/neglected_diseases/diseases/Nodding_syndrom_Kampala_Report_2012.pdf. Accessed April 10, 2018.
Dowell SF et al. 2013 Nodding syndrome. Emerg Infect Dis 19: 1374–1384.
Idro R , Namusoke H , Abbo C , Mutamba BB , Kakooza-Mwesige A , Opoka RO , Musubire AK , Mwaka AD , Opar BT , 2014. Patients with nodding syndrome in Uganda improve with symptomatic treatment: a cross-sectional study. BMJ Open 4: e006476.
McMahon JP , 1967. A review of the control of Simulium vectors of onchocerciasis. Bull World Health Org 37: 415–430.
Mmbando BP , Suykerbuyk P , Mnacho M , Kakorozya A , Matuja W , Hendy A , Greter H , Makunde WH , Colebunders R , 2018. High prevalence of epilepsy in two rural onchocerciasis endemic villages in the Mahenge area, Tanzania, after 20 years of community directed treatment with ivermectin. Infect Dis Poverty 7: 64.
Kaiser C et al. 2019. Onchocerciasis-associated epilepsy: another piece in the puzzle from the Mahenge mountains, southern Tanzania. Infect Dis Poverty 8: 35.
Foltz JL et al. 2013. An epidemiologic investigation of potential risk factors for nodding syndrome in Kitgum district, Uganda. PLoS One 8: e66419.
Spencer PS et al. 2013. Nodding Syndrome in Mundri county, South Sudan: environmental, nutritional and infectious factors. Afr Health Sci 13: 183–204.
CDC , 2012. Nodding syndrome – South Sudan, 2011. Morb Mortal Wkly Rep 61: 52–53.
Abd-Elfarag G et al. 2020. Persons with onchocerciasis-associated epilepsy and nodding seizures have a more severe form of epilepsy with more cognitive impairment and higher levels of Onchocerca volvulus infection. Epileptic Disord 22: 301–308.
Pion SDS et al. 2009. Epilepsy in onchocerciasis endemic areas: systematic review and meta-analysis of population-based surveys. PLoS Negl Trop Dis 3: e461.
Kaiser C , Pion SDS , Boussinesq M , 2013. Case-control studies on the relationship between onchocerciasis and epilepsy: systematic review and meta-analysis. PLoS Negl Trop Dis 7: e461.
Ngugi A et al. 2013. Prevalence of active convulsive epilepsy in sub-Saharan Africa and associated risk factors: cross-sectional and case-control studies. Lancet Neurol 12: 253–263.
Chesnais CB , Nana-Djeunga HC , Njamnshi AK , Lenou-Nanga CG , Boulle C , Bissek AZ , Kamgno J , Colebunders R , Boussinesq M , 2018. The temporal relationship between onchocerciasis and epilepsy: a population-based cohort study. Lancet Infect Dis 18: 1278–1286.
Chesnais CB , Bizet C , Campillo JT , Njamnshi WY , Bopda J , Nwane P , Pion SD , Njamnshi AK , Boussinesq M , 2020. A second population-based cohort study in Cameroon confirms the temporal relationship between onchocerciasis and epilepsy. Open Forum Infect Dis 7: ofaa206.
Sejvar JJ et al. 2013. Clinical, neurological, and electrophysiological features of nodding syndrome in Kitgum, Uganda: an observational case series. Lancet Neurol 12: 166–174.
Gumisiriza N et al. 2020. Prevalence and incidence of nodding syndrome and other forms of epilepsy in onchocerciasis-endemic areas in northern Uganda after the implementation of onchocerciasis control measures. Infect Dis Poverty 9: 12.
Bhwana D , Mmbando BP , Dekker MCJ , Mnacho M , Kakorozya A , Matuja W , Makunde WH , Weckhuysen S , Colebunders R , 2019. Clinical presentation of epilepsy in six villages in an onchocerciasis endemic area in Mahenge, Tanzania. Epileptic Disord 21: 425–435.
Colebunders R et al. 2018. High prevalence of onchocerciasis-associated epilepsy in villages in Maridi county, Republic of South Sudan: a community-based survey. Seizure 63: 93–101.
Colebunders R et al. 2018. Clinical characteristics of onchocerciasis-associated epilepsy in villages in Maridi county, Republic of South Sudan. Seizure 62: 108–115.
Lenaerts E et al. 2018. High prevalence of epilepsy in onchocerciasis endemic health areas in Democratic Republic of the Congo. Infect Dis Poverty 7: 68.
Siewe Fodjo JN et al. 2019. Onchocerciasis-associated epilepsy in the Democratic Republic of Congo: clinical description and relationship with microfilarial density. PLoS Negl Trop Dis 13: e0007300.
Colebunders R , Siewe Fodjo JN , Hopkins A , Hotterbeekx A , Lakwo TL , Kalinga A , Logora MY , Basáñez MG , 2019. From river blindness to river epilepsy: implications for onchocerciasis elimination programmes. PLoS Negl Trop Dis 13: e0007407.
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Nakalanga syndrome is a childhood developmental disorder that has been reported from various parts of sub-Saharan Africa with the major sign of retarded growth, regularly combined with physical deformities, impaired mental and pubertal development, and epilepsy. We present a follow-up over a 24-year period of a patient living in the Itwara onchocerciasis focus of western Uganda. We demonstrate the strong similarity of Nakalanga syndrome to the more recently described Nodding syndrome, and we discuss the possible causation of both disorders by onchocerciasis. We suggest that the growing knowledge about the tight interconnections between Nakalanga and nodding syndrome, other forms of epilepsy, and onchocerciasis should be taken into consideration in a revised classification system.
Authors’ addresses: Christoph Kaiser, General Pediatrics, Practice for Child and Adolescent Health, Baden-Baden, Germany, E-mail: firstname.lastname@example.org. Christine Mugisa, Department of Health, Primary Health Care, Fort Portal, Uganda, E-mail: email@example.com. Donozio Kisembo, Nursing, Kagando School of Nursing and Midwifery, Kasese, Uganda, E-mail: firstname.lastname@example.org. Nolbert Gumisiriza, Kabale University, School of Medicine, Kabale, Uganda, E-mail: email@example.com. Robert Colebunders, Global Health Institute, University of Antwerp, Antwerp, Belgium, E-mail: firstname.lastname@example.org. Ephraim Tukesiga, Vector Control Unit, Minstry of Health, Fort Portal, Uganda, E-mail: email@example.com. Walter Kipp, Department of Public Health Services, Faculty of Medicine and Dentistry¸ University of Alberta, Edmonton, Canada, E-mail: firstname.lastname@example.org. George Asaba, Pediatrics, Fort Portal Regional Referral Hospital, Fort Portal, Uganda, E-mail: email@example.com.