The Pathogenesis of Nodding Syndrome

Tory P. Johnson, James Sejvar, Thomas B. Nutman, Avindra Nath

Research output: Contribution to journalReview articlepeer-review

6 Scopus citations


Nodding syndrome is a rare, enigmatic form of pediatric epilepsy that has occurred in an epidemic fashion beginning in the early 2000s in geographically distinct regions of Africa. Despite extensive investigation, the etiology of nodding syndrome remains unclear, although much progress has been made in understanding the pathogenesis of the disease, as well as in treatment and prevention. Nodding syndrome is recognized as a defined disease entity, but it is likely one manifestation along a continuum of Onchocerca volvulus-associated neurological complications. This review examines the epidemiology of nodding syndrome and its association with environmental factors. It provides a critical analysis of the data that support or contradict the leading hypotheses of the etiologies underlying the pathogenesis of the syndrome. It also highlights the important progress made in treating and preventing this devastating neurological disease and prioritizes important areas for future research.

Original languageEnglish (US)
Pages (from-to)395-417
Number of pages23
JournalAnnual Review of Pathology: Mechanisms of Disease
StatePublished - Jan 24 2020


  • nodding syndrome, epilepsy, Onchocerca volvulus, tau, autoantibody, immune mediated

ASJC Scopus subject areas

  • General Medicine


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