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. 2021 Sep;6(3):513-527.
doi: 10.1002/epi4.12510. Epub 2021 Aug 3.

Epilepsy in the Sanaga-Mbam valley, an onchocerciasis-endemic region in Cameroon: electroclinical and neuropsychological findings

Alexandre Morin  1 , Maxime Guillaume  1 , Leonard Ngarka  2   3   4 , Godwin Y Tatah  2   3   5 , Joseph Nelson Siewe Fodjo  2   3   6 , Guillaume Wyart  7 , Ghislain Nokam  8 , Thierry Tchoumi  9 , Mary Bello Nkinin  4 , Wepnyu Y Njamnshi  2   3   4 , Eric-Samuel Chokote  2   3 , Michel Boussinesq  10   11   12 , Robert Colebunders  6 , Cédric B Chesnais  10   11   12 , Gilles Gargala  13 , Dominique Parain  14 , Alfred K Njamnshi  2   3   4
Affiliations

Epilepsy in the Sanaga-Mbam valley, an onchocerciasis-endemic region in Cameroon: electroclinical and neuropsychological findings

Alexandre Morin et al. Epilepsia Open. 2021 Sep.

Abstract

Objective: Epilepsy is highly prevalent in onchocerciasis-endemic African regions. Various types of epilepsy have been described in such regions based essentially on clinical characteristics.

Methods: We conducted a clinical, neurophysiological and neuropsychological study of epilepsy in the onchocerciasis-endemic region of Ntui, Sanaga-Mbam area, Cameroon.

Results: One hundred and eighty-seven persons with presumed epilepsy were recruited in an epilepsy clinic in Ntui. Epilepsy was clinically confirmed in 144 (79%) subjects, 69 (46.0%) of them met the onchocerciasis-associated epilepsy (OAE) criteria, and 51 of 106 tested (48.1%) presented Ov16 antibodies. Electroencephalograms (EEG) were recorded in 91 participants, of which 36 (33%) were considered abnormal and 27 of 36 (75%) revealed bifrontotemporal spike and slow waves. Concerning the neuropsychological evaluation, 29% showed severe global cognitive impairment, 28% severe episodic memory impairment, and 66% severe frontal cognitive impairment. Half of the persons with epilepsy (PWE) suffered from a mental disorder.

Significance: In PWE in the Sanaga-Mbam area in Cameroon, we observed EEG patterns similar to those described among persons with OAE, including nodding syndrome in other onchocerciasis-endemic areas. Most PWE presented with severe cognitive impairment. We hypothesize that onchocerciasis may induce neurocognitive disorders and epilepsy via a mechanism that involves mainly the frontal and temporal regions of the brain.

Keywords: Cameroon; electrophysiology; epilepsy; neuropsychology; nodding syndrome; onchocerciasis.

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Conflict of interest statement

None of the authors have any conflict of interest to disclose.

Figures

FIGURE 1
FIGURE 1
EEG: bifrontotemporal spike and wave pattern
See this image and copyright information in PMC

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