Epilepsy may be associated with living in a region endemic or hyperendemic for Onchocerca volvulus. Areas with reduction in onchocerciasis show a decline in the prevalence of epilepsy.
Types of epilepsy:
(1) generalized tonic-clonic seizures
(2) head nodding
(3) other
Other findings;
(1) skin and ocular changes of onchocerciasis
(2) impaired cognitive function
(3) features of Nakalanga syndrome (growth retardation, etc)
Criteria for onchocerciasis-associated epilepsy:
(1) living >= 3 years in a region endemic for Onchocerca
(2) high prevalence of epilepsy in the community
(3) history >= 2 unprovoked epileptic seizures >= 24 hours apart
(4) no other obvious cause for the epilepsy
(5) onset of epilepsy between ages 3 to 18 years
(6) normal psychomotor development prior to first seizure
EEGs show generalized epileptiform discharges and episodes of slowing.
