Nodding Syndrome Symptoms
(Nodding Disease)

Medical Author:
Medical Editor:

Imagine a syndrome so unusual that it has been reported in only one small corner of the world. Nodding syndrome may be such a condition. Nodding syndrome, also referred to as nodding disease, is characterized by a nodding behavior of the head that is accompanied by convulsions, staring spells, or other manifestations of seizures. The condition mainly affects children aged 5-15 years and has been reported in Africa, specifically in South Sudan, Northern Uganda, and southern Tanzania. Reports suggest over 3,000 children have this condition and about 170 have died from it.

The U.S. Centers for Disease Control and Prevention (CDC) began an investigation of this unusual neurologic condition in May 2011, when CDC officials conducted a study of the illness in two different geographic locations in South Sudan. Current infection with the parasite Onchocerca volvulus (as diagnosed by skin snip biopsy) was more common in the patients with nodding syndrome than in the general population. About 73% of affected patients had onchocerciasis, compared to about 47% of nonaffected individuals. Still, no definitive reason has been identified that would correlate parasite infection with the symptoms of nodding syndrome. However, the CDC recommended the continued use of mass treatment against onchocerciasis until more is understood about this puzzling condition. In addition, the CDC plans to investigate nutritional and chemical toxins as other potential participants in or causes of this condition.