Location: sub-Saharan Africa (South Sudan, Tanzania, Uganda)
A suspected case:
(1) previously normal
(2) head nodding episodes reported on >= 2 occasions
A probable case is a suspected case with:
(1) onset when 3 to 18 years of age
(2) one or more of the following:
(2a) cognitive decline, other types of seizures or other neurologic abnormalities
(2b) similar cases clustered in time or space
(2c) episodes triggered by cold weather or food
(2d) stunting or wasting
(2e) psychiatric symptoms (behavioral problems)
where:
• The original criteria also included under a probable case (1) delayed sexual and physical development and (2) frequency of nodding 5 to 20 per minute.
A confirmed case involves a probable case with one or more of the following:
(1) observation by a trained healthcare worker
(2) nodding episode captures on videotape
(3) documentation of atonice seizures during nodding by EEG, EMG or video
