Nodding syndrome in Ugandan children—clinical features, brain imaging and complications: a case series

Simple item page
dc.contributor.authorIdro, Richard
dc.contributor.authorOpoka, Robert Opika
dc.contributor.authorAanyu, Hellen T
dc.contributor.authorPiloya-Were, Theresa
dc.contributor.authorNamusoke, Hanifa
dc.contributor.authorMusoke, Sarah Bonita
dc.contributor.authorNalugya, Joyce
dc.contributor.authorBangirana, Paul
dc.contributor.authorMwaka, Amos Deogratius
dc.contributor.authorWhite, Steven
dc.contributor.authorChong, Kling
dc.contributor.authorAtai-Omoruto, Anne D
dc.contributor.authorMworozi, Edison
dc.contributor.authorNankunda, Jolly
dc.contributor.authorKiguli, Sarah
dc.contributor.authorAceng, Jane Ruth
dc.contributor.authorTumwine, James K
dc.contributor.authorKakooza-Mwesige, Angelina
dc.date.accessioned2024-03-25T13:01:16Z
dc.date.available2024-03-25T13:01:16Z
dc.date.issued2013-04-08
dc.description.abstractObjectives: Nodding syndrome is a devastating neurological disorder of uncertain aetiology affecting children in Africa. There is no diagnostic test, and risk factors and symptoms that would allow early diagnosis are poorly documented. This study aimed to describe the clinical, electrophysiological and brain imaging(MRI) features and complications of nodding syndrome in Ugandan children. Design: Case series. Participants: 22 children with nodding syndrome brought to Mulago National Referral Hospital for assessment. Outcome measures: Clinical features, physical and functional disabilities, EEG and brain MRI findings and a staging system with a progressive development of symptoms and complications. Results: The median age of symptom onset was 6 (range 4–10) years and median duration of symptoms was 8.5 (range 2–11) years. 16 of 22 families reported multiple affected children. Physical manifestations and complications included stunting, wasting, lip changes and gross physical deformities. The bone age was delayed by 2 (range 1–6) years. There was peripheral muscle wasting and progressive generalised wasting. Four children had nodding as the only seizure type;18 in addition had myoclonic, absence and/or generalised tonic–clonic seizures developing 1–3 years after the onset of illness. Psychiatric manifestations included wandering, aggression, depression and disordered perception. Cognitive assessment in three children demonstrated profound impairment. The EEG was abnormal in all, suggesting symptomatic generalised epilepsy in the majority. There were different degrees of cortical and cerebellar atrophy on brain MRI, but no hippocampal changes. Five stages with worsening physical, EEG and brain imaging features were identified: a prodrome, the development of head nodding and cognitive decline, other seizure types, multiple complications and severe disability. Conclusions: Nodding syndrome is a neurological disorder that may be characterised as probably symptomatic generalised epilepsy. Clinical manifestations and complications develop in stagesen_US
dc.description.sponsorshipThe Government of Uganda through the Ministry of Health and by the Waterloo Foundation through grant number 1025/1490 to Dr ldro.en_US
dc.identifier.citation: Idro R, Opoka RO, Aanyu HT, et al. Nodding syndrome in Ugandan children—clinical features, brain imaging and complications: a case series. BMJ Open 2013;3:e002540. doi:10.1136/bmjopen-2012- 002540en_US
dc.identifier.uri10.1136/bmjopen-2012- 002540
dc.identifier.urihttps://hdl.handle.net/20.500.14270/478
dc.language.isoenen_US
dc.publisherBMJ Openen_US
dc.relation.ispartofseriesBMJ Open;2013;3:e002540
dc.subjectNodding syndromeen_US
dc.subjectepileptic encephalopathy.en_US
dc.subjectneurological disorderen_US
dc.subjectbrain imagingen_US
dc.titleNodding syndrome in Ugandan children—clinical features, brain imaging and complications: a case seriesen_US
dc.typeArticleen_US

Files

Original bundle
Now showing 1 - 1 of 1
Thumbnail Image
Name:
Kitara_Article2_2013.pdf
Size:
1018.43 KB
Format:
Adobe Portable Document Format
Description:
pdf article file
Download
License bundle
Now showing 1 - 1 of 1
No Thumbnail Available
Name:
license.txt
Size:
1.71 KB
Format:
Item-specific license agreed upon to submission
Description:
Download

Collections

Research Articles