مرکز منطقه ای اطلاع رساني علوم و فناوري - Proposed guidelines for the management of nodding syndrome

Author/Authors :

Idro, R Oxford University - Centre for Tropical Medicine - Nuffield Department of Medicine, UK , Idro, R Makerere University - Mulago hospital, College of Health Sciences - Department of Paediatrics and Child Health, Uganda , Musubire, K A Makerere University - Mulago hospital, College of Health Sciences - Department of Internal Medicine, Uganda , Byamah Mutamba, B Butabika National Referral Mental Hospital, Uganda , Namusoke, H Makerere University - Mulago hospital, College of Health Sciences - Department of Paediatrics and Child Health, Uganda , Muron, J Butabika National Referral Mental Hospital, Uganda , Abbo, C Makerere University - Mulago hospital, College of Health Sciences - Department of Psychiatry, Uganda , Oriyabuzu, R Makerere University - Mulago hospital, College of Health Sciences - Department of Psychiatry, Uganda , Ssekyewa, J Makerere University - Mulago hospital, College of Health Sciences - Department of Psychiatry, Uganda , Okot, C World Health Organization - Uganda Country Office, Uganda , Mwaka, D Makerere University - Mulago hospital, College of Health Sciences - Department of Internal Medicine, Uganda , Ssebadduka, P Makerere University - Mulago hospital, College of Health Sciences - Department of Obstetrics and Gynaecology, Uganda , Makumbi, I Ministry of Health Headquarters, Uganda , Opar, B Ministry of Health Headquarters, Uganda , Aceng, JR Ministry of Health Headquarters, Uganda , Mbonye, AK Ministry of Health Headquarters, Uganda , Mbonye, AK Makerere University - School of Public Health, College of Health Sciences - Department of Community Health Behavioral Sciences, Uganda , idro, r. department of paediatrics and child health,mulago hospital,makerere university college of health sciences,kampala,uganda,centre for tropical medicine,nuffield department of medicine, United Kingdom , musubire, k.a. department of internal medicine,mulago hospital,makerere university college of health sciences, Uganda , byamah mutamba, b. butabika national referral mental hospital, Uganda , namusoke, h. department of paediatrics and child health,mulago hospital,makerere university college of health sciences, Uganda , muron, j. butabika national referral mental hospital, Uganda , abbo, c. department of psychiatry,mulago hospital,makerere university college of health sciences, Uganda , oriyabuzu, r. department of psychiatry,mulago hospital,makerere university college of health sciences, Uganda , ssekyewa, j. department of psychiatry,mulago hospital,makerere university college of health sciences, Uganda , okot, c. world health organization,uganda country office, Uganda , mwaka, d. department of internal medicine,mulago hospital,makerere university college of health sciences, Uganda , ssebadduka, p. department of obstetrics and gynaecology,mulago hospital,makerere university college of health sciences, Uganda , makumbi, i. ministry of health headquarters, Uganda , opar, b. ministry of health headquarters, Uganda , aceng, j.r. ministry of health headquarters, Uganda , mbonye, a.k. ministry of health headquarters,kampala,uganda,department of community health and behavioral sciences,school of public health,makerere university college of health sciences, Uganda

Abstract :

Nodding Syndrome is a poorly understood neurologic disorder of unknown aetiology that affects children and adolescents in Africa. Recent studies have suggested that the head nods are due to atonic seizures and Nodding Syndrome may be classified as probably symptomatic generalised epilepsy. As part of the Ugandan Ministry of Health clinical management response, a multidisciplinary team developed a manual to guide the training of health workers with knowledge and skills to manage the patients. In the absence of a known cause, it was decided to offer symptomatic care. The objective is to relieve symptoms, offer primary and secondary prevention for disability and rehabilitation to improve function. Initial management focuses on the most urgent needs of the patient and the immediate family until ‘stability’ is achieved. The most important needs were considered as seizure control, management of behavioural and psychiatric difficulties, nursing care, nutritional and subsequently, physical and cognitive rehabilitation. This paper summarises the processes by which the proposed guidelines were developed and provides an outline of the specific treatments currently being provided for the patients.