ArticleBMJ open2014
Patients with nodding syndrome in Uganda improve with symptomatic treatment: a cross-sectional study.
Article in BMJ open, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 37 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
37 citing papers in PubMed, 62 citations in OpenAlex.
- Ivermectin as an adjuvant to anti-epileptic treatment in persons with onchocerciasis-associated epilepsy: A randomized proof-of-concept clinical trial.PLoS neglected tropical diseases · 2020Trial
- Setting up a clinical trial for a novel disease: a case study of the Doxycycline for the Treatment of Nodding Syndrome Trial - challenges, enablers and lessons learned.Global health action · 2018Trial
- Catatonia in Ugandan children with nodding syndrome and effects of treatment with lorazepam: a pilot study.BMC research notes · 2015Trial
- Article
- Cognitive, Behavioral, and Emotional Manifestations in Nodding Syndrome: A Neuropsychological Narrative Review.Revista de neurologia · 2026Review
- The Nodding syndrome cerebrospinal fluid proteome: a lens into neurodevelopmental failure consistent with environmentally triggeredFrontiers in molecular neuroscience · 2026Article
- Evaluation of the nutritional quality of food composites developed from local ingredients to target the needs of persons experiencing nodding syndrome in Northern Uganda.Scientific reports · 2025Article
- Community-based epilepsy care in an onchocerciasis-endemic area: A 3-year cohort study in Mahenge, Tanzania.Epilepsia · 2025Article
- Parasitic, bacterial, viral, immune-mediated, metabolic and nutritional factors associated with nodding syndrome.Brain communications · 2023Article
- Nodding Syndrome: A Scoping Review.Tropical medicine and infectious disease · 2021Article
- First description of Nodding Syndrome in the Central African Republic.PLoS neglected tropical diseases · 2021Article
- Systemic and cerebrospinal fluid immune and complement activation in Ugandan children and adolescents with long-standing nodding syndrome: A case-control study.Epilepsia open · 2021Article
- Household poverty, schooling, stigma and quality of life in adolescents with epilepsy in rural Uganda.Epilepsy & behavior : E&B · 2021Article
- Association Between Ov16 Seropositivity and Neurocognitive Performance Among Children in Rural Cameroon: a Pilot Study.Journal of pediatric neuropsychology · 2021Article
- Putative Autoantigen Leiomodin-1 Is Expressed in the Human Brain and in the Membrane Fraction of Newly Formed Neurons.Pathogens (Basel, Switzerland) · 2020Article
- Article
- Economic burden of the persistent morbidity of nodding syndrome on caregivers in affected households in Northern Uganda.PloS one · 2020Article
- Nodding syndrome: a concise review.Brain communications · 2020Review
- Long-Term Impact of War, Civil War, and Persecution in Civilian Populations-Conflict and Post-Traumatic Stress in African Communities.Frontiers in psychiatry · 2020Article
- "Those who died are the ones that are cured". Walking the political tightrope of Nodding Syndrome in northern Uganda: Emerging challenges for research and policy.PLoS neglected tropical diseases · 2019Article
Corrections and comments
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Authors and funding
9 authors at 3 institutions in 4 countries.
Funding
Abstract
objectivesNodding syndrome (NS) is a poorly understood neurological disorder affecting thousands of children in Africa. In March 2012, we introduced a treatment intervention that aimed to provide symptomatic relief. This intervention included sodium valproate for seizures, management of behaviour and emotional difficulties, nutritional therapy and physical rehabilitation. We assessed the clinical and functional outcomes of this intervention after 12 months of implementation.
designThis was a cross-sectional study of a cohort of patients with NS receiving the specified intervention. We abstracted preintervention features from records and compared these with the current clinical status. We performed similar assessments on a cohort of patients with other convulsive epilepsies (OCE) and compared the outcomes of the two groups.
participantsParticipants were patients with WHO-defined NS and patients with OCE attending the same centres. OUTCOME MEASURES: The primary outcome was the proportion of patients with seizure freedom (≥1 month without seizures). Secondary outcome measures included a reduction in seizure frequency, resolution of behaviour and emotional difficulties, and independence in basic self-care.
resultsPatients with NS had had a longer duration of symptoms (median 5 (IQR 3, 6) years) compared with those with OCE (4 (IQR 2, 6) years), p<0.001. The intervention resulted in marked improvements in both groups; compared to the preintervention state, 121/484 (25%) patients with NS achieved seizure freedom and there was a >70% reduction in seizure frequency; behaviour and emotional difficulties resolved in 194/327 (59%) patients; 193/484 (40%) patients had enrolled in school including 17.7% who had earlier withdrawn due to severe seizures, and over 80% had achieved independence in basic self-care. These improvements were, however, less than that in patients with OCE of whom 243/476 (51.1%) patients were seizure free and in whom the seizure frequency had reduced by 86%.
conclusionsUgandan children with NS show substantial clinical and functional improvements with symptomatic treatments suggesting that NS is probably a reversible encephalopathy.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.