Onchocerciasis-associated epilepsy: From recent epidemiological and clinical findings to policy implications

Summary A high prevalence of epilepsy is reported in many onchocerciasis endemic regions. In this paper we discuss recent epidemiological and clinical aspects as well as public health implications of onchocerciasis associated epilepsy (OAE) and propose a strategy to reduce the burden of disease. OAE probably presents in a variety of clinical manifestations including the nodding syndrome and the Nakalanga syndrome. The most common clinical presentation is however generalized (primarily tonic-clonic) seizures. A characteristic of OAE is the onset of seizures between the ages of 3-18 years and clustering in certain families and villages close to rapid flowing blackfly infested rivers. A strategy combining active surveillance for epilepsy with early treatment with anti-epileptic drugs and prevention of onchocerciasis by increasing the geographical and therapeutic coverage of community-directed treatment with ivermectin (CDTi) may considerably decrease the burden of disease. This article is protected by copyright. All rights reserved.