Nodding syndrome research revisited

•Onchocerca volvulus appears to be able to trigger epilepsy, including nodding syndrome.•Ivermectin seems to decrease the incidence of onchocerciasis-associated epilepsy.•It remains to be elucidated whether O. volvulus induces epilepsy directly or indirectly.•An unknown pathogen transmitted by black...

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Bibliographic Details
Published in:International journal of infectious diseases 2021-03, Vol.104, p.739-741
Main Authors: Vieri, Melissa Krizia, Hendy, Adam, Mokili, John L., Colebunders, Robert
Format: Article
Language:English
Subjects:
Animals
Biomedical Research - trends
Blackflies
Epilepsy
Humans
Ivermectin
Nodding Syndrome - etiology
Onchocerca volvulus - physiology
Onchocerciasis
Onchocerciasis - complications
Onchocerciasis - parasitology
Prevalence
Simulium
Viruses
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Summary:•Onchocerca volvulus appears to be able to trigger epilepsy, including nodding syndrome.•Ivermectin seems to decrease the incidence of onchocerciasis-associated epilepsy.•It remains to be elucidated whether O. volvulus induces epilepsy directly or indirectly.•An unknown pathogen transmitted by blackflies could still be a contributing factor.•An endosymbiont of O. volvulus could also contribute to disease. Nodding syndrome is one of several forms of onchocerciasis-associated epilepsy (OAE) seen among children in areas formerly hyperendemic for the transmission of Onchocerca volvulus. These forms of epilepsy are highly prevalent and clustered in certain villages located close to blackfly (Diptera: Simuliidae) breeding sites. OAE presents with a wide spectrum of seizures, including generalized tonic-clonic and head nodding seizures, impaired cognitive function, growth stunting and delayed puberty. In 2014, the present authors published a perspective paper in this journal which hypothesized that nodding syndrome may be caused by either a neurotropic virus transmitted by blackflies or an endosymbiont present within the O. volvulus parasite. Seven years later, this critical review presents progress in nodding syndrome research, and assesses whether it is still plausible that a neurotropic virus or endosymbiont could be the cause.
ISSN:1201-9712
1878-3511
DOI:10.1016/j.ijid.2021.02.006