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News From the Centers for Disease Control and Prevention
October 9, 2013

Nodding Syndrome Still Mystifies

JAMA. 2013;310(14):1438. doi:10.1001/jama.2013.278211

It’s been linked with onchocerciasis and vitamin B6 deficiency. Eating red sorghum or baboon brain aren’t likely causes, but consuming improperly prepared cassava containing cyanide is a possibility. Fifty years after being recognized as a seizure disorder, the underlying cause of the condition now known as nodding syndrome remains a mystery.

A recent review article in the journal Emerging Infectious Diseases traces 2 decades’ worth of attempts to pin down the etiology of these atonic seizure episodes that are considered an epidemic in eastern Africa. Clinicians observed nodding syndrome in Tanzania, Liberia, and western Uganda in the 1960s, but it wasn’t considered as a distinct clinical entity until the 1990s in South Sudan.