Abstract:
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, however, is generalized (primarily tonic-clonic) seizures.
A characteristic of OAE is the onset of seizures between the ages of 3 and
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 antiepileptic 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.
