{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T05:30:38Z","timestamp":1790400638490,"version":"4.1.0"},"reference-count":48,"publisher":"Elsevier BV","issue":"10","license":[{"start":{"date-parts":[[2019,12,1]],"date-time":"2019-12-01T00:00:00Z","timestamp":1575158400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2019,12,1]],"date-time":"2019-12-01T00:00:00Z","timestamp":1575158400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2019,10,1]],"date-time":"2019-10-01T00:00:00Z","timestamp":1569888000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100010987","name":"American Neurological Association","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100010987","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["clinicalkey.fr","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Revue Neurologique"],"published-print":{"date-parts":[[2019,12]]},"DOI":"10.1016\/j.neurol.2019.09.005","type":"journal-article","created":{"date-parts":[[2019,11,18]],"date-time":"2019-11-18T09:05:34Z","timestamp":1574067934000},"page":"679-685","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":17,"title":["Nodding syndrome phenotypes"],"prefix":"10.1016","volume":"175","author":[{"given":"P.S.","family":"Spencer","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Mazumder","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V.S.","family":"Palmer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.S.","family":"Pollanen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.neurol.2019.09.005_bib0005","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1111\/j.1600-0447.1965.tb04970.x","article-title":"Epilepsy in the Wapogoro tribe in Tanganyika","volume":"41","author":"Aall-Jilek","year":"1965","journal-title":"Acta Psychiat Scand"},{"key":"10.1016\/j.neurol.2019.09.005_bib0010","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1258\/td.2010.090373","article-title":"Clinical characteristics of people with head nodding in southern Tanzania","volume":"40","author":"Winkler","year":"2010","journal-title":"Trop Doct"},{"key":"10.1016\/j.neurol.2019.09.005_bib0015","first-page":"176","article-title":"Nodding syndrome: origins and natural history of a longstanding epileptic disorder in sub-Saharan Africa","volume":"13","author":"Spencer","year":"2013","journal-title":"Afr Health Sci"},{"key":"10.1016\/j.neurol.2019.09.005_bib0020","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1111\/epi.12483","article-title":"A longitudinal study on nodding syndrome \u2013 a new African epilepsy disorder","volume":"55","author":"Winkler","year":"2014","journal-title":"Epilepsia"},{"key":"10.1016\/j.neurol.2019.09.005_bib0025","first-page":"242","article-title":"Clinical and epidemiologic characteristics of nodding syndrome in Mundri County, southern Sudan","volume":"12","author":"Tumwine","year":"2012","journal-title":"Afr Health Sci"},{"key":"10.1016\/j.neurol.2019.09.005_bib0030","first-page":"52","article-title":"Nodding syndrome \u2013 South Sudan, 2011","volume":"61","author":"Centers for Disease Control (CDC)","year":"2012","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"10.1016\/j.neurol.2019.09.005_bib0035","first-page":"183","article-title":"Nodding syndrome in Mundri county, South Sudan: environmental, nutritional and infectious factors","volume":"13","author":"Spencer","year":"2013","journal-title":"Afr Health Sci"},{"issue":"5","key":"10.1016\/j.neurol.2019.09.005_bib0040","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2012-002540","article-title":"Nodding syndrome in Ugandan children \u2013 Clinical features, brain imaging and complications: a case series","volume":"3","author":"Idro","year":"2013","journal-title":"BMJ Open"},{"key":"10.1016\/j.neurol.2019.09.005_bib0045","doi-asserted-by":"crossref","first-page":"166","DOI":"10.1016\/S1474-4422(12)70321-6","article-title":"Clinical, neurological, and electrophysiological features of nodding syndrome in Kitgum, Uganda: an observational case series","volume":"12","author":"Sejvar","year":"2013","journal-title":"Lancet Neurol"},{"key":"10.1016\/j.neurol.2019.09.005_bib0050","doi-asserted-by":"crossref","first-page":"e66419","DOI":"10.1371\/journal.pone.0066419","article-title":"An epidemiologic investigation of potential risk factors for Nodding syndrome in Kitgum District Uganda","volume":"8","author":"Foltz","year":"2013","journal-title":"PLoS One"},{"key":"10.1016\/j.neurol.2019.09.005_bib0055","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1016\/j.jns.2016.08.023","article-title":"Environmental, dietary and case-control study of Nodding Syndrome in Uganda: a post-measles brain disorder triggered by malnutrition?","volume":"369","author":"Spencer","year":"2016","journal-title":"J Neurol Sci"},{"key":"10.1016\/j.neurol.2019.09.005_bib0060","doi-asserted-by":"crossref","first-page":"e0005201","DOI":"10.1371\/journal.pntd.0005201","article-title":"Nakalanga syndrome: clinical characteristics, potential causes, and its relationship with recently described Nodding syndrome","volume":"11","author":"F\u00f6ger","year":"2017","journal-title":"PLoS Negl Trop Dis"},{"key":"10.1016\/j.neurol.2019.09.005_bib0065","doi-asserted-by":"crossref","first-page":"508","DOI":"10.1684\/epd.2018.1012","article-title":"The natural history of nodding syndrome","volume":"20","author":"Idro","year":"2018","journal-title":"Epileptic Disord"},{"key":"10.1016\/j.neurol.2019.09.005_bib0070","doi-asserted-by":"crossref","first-page":"825","DOI":"10.1186\/s13104-015-1805-5","article-title":"Catatonia in Ugandan children with nodding syndrome and effects of treatment with lorazepam: a pilot study","volume":"8","author":"Kakooza-Mwesige","year":"2015","journal-title":"BMC Res Notes"},{"key":"10.1016\/j.neurol.2019.09.005_bib0075","doi-asserted-by":"crossref","first-page":"858","DOI":"10.1186\/1756-0500-7-858","article-title":"Physical growth, puberty and hormones in adolescents with Nodding Syndrome: a pilot study","volume":"7","author":"Piloya-Were","year":"2014","journal-title":"BMC Res Notes"},{"key":"10.1016\/j.neurol.2019.09.005_bib0080","doi-asserted-by":"crossref","first-page":"228","DOI":"10.11604\/pamj.2018.29.228.13627","article-title":"Treatment and rehabilitation outcomes of children affected with nodding syndrome in Northern Uganda: a descriptive case series","volume":"29","author":"Gazda","year":"2018","journal-title":"Pan Afr Med J"},{"key":"10.1016\/j.neurol.2019.09.005_bib0085","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1016\/j.seizure.2015.07.006","article-title":"Neurophysiological and clinical findings on Nodding Syndrome in 21 South Sudanese children and a review of the literature","volume":"31","author":"de Polo","year":"2015","journal-title":"Seizure"},{"key":"10.1016\/j.neurol.2019.09.005_bib0090","first-page":"529","article-title":"MRI findings in people with epilepsy and nodding syndrome in an area endemic for onchocerciasis: an observational study","volume":"13","author":"Winkler","year":"2013","journal-title":"Afr Health Sci"},{"key":"10.1016\/j.neurol.2019.09.005_bib0095","doi-asserted-by":"crossref","first-page":"691","DOI":"10.1007\/s00401-018-1909-9","article-title":"Nodding syndrome in Uganda is a tauopathy","volume":"136","author":"Pollanen","year":"2018","journal-title":"Acta Neuropathol"},{"key":"10.1016\/j.neurol.2019.09.005_bib0100","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1016\/j.seizure.2018.11.004","article-title":"High prevalence of onchocerciasis-associated epilepsy in villages in Maridi County. Republic of South Sudan: A community-based survey","volume":"63","author":"Colebunders","year":"2018","journal-title":"Seizure"},{"key":"10.1016\/j.neurol.2019.09.005_bib0105","doi-asserted-by":"crossref","first-page":"1049","DOI":"10.1093\/jnen\/nlz090","article-title":"Neuroinflammation and not tauopathy is a predominant pathological signature of Nodding syndrome","volume":"78","author":"Hotterbeekx","year":"2019","journal-title":"J Neuropath Exp Neurol"},{"key":"10.1016\/j.neurol.2019.09.005_bib0110","doi-asserted-by":"crossref","first-page":"123","DOI":"10.11604\/pamj.2016.24.123.8409","article-title":"Reduced plasma concentrations of vitamin B6 and increased plasma concentrations of the neurotoxin 3-hydroxykynurenine are associated with nodding syndrome: a case control study in Gulu and Amuru districts, Northern Uganda","volume":"24","author":"Obol","year":"2016","journal-title":"Pan Afr Med J"},{"key":"10.1016\/j.neurol.2019.09.005_bib0115","doi-asserted-by":"crossref","first-page":"490","DOI":"10.1016\/j.pt.2017.05.001","article-title":"Nodding Syndrome in the spotlight \u2013 Placing recent findings in perspective","volume":"33","author":"Spencer","year":"2017","journal-title":"Trends Parasitol"},{"issue":"377","key":"10.1016\/j.neurol.2019.09.005_bib0120","doi-asserted-by":"crossref","DOI":"10.1126\/scitranslmed.aaf6953","article-title":"Nodding syndrome may be an autoimmune reaction to the parasitic worm Onchocerca volvulus","volume":"9","author":"Johnson","year":"2017","journal-title":"Sci Transl Med"},{"key":"10.1016\/j.neurol.2019.09.005_bib0125","first-page":"2459","article-title":"Leiomodin 1, a new serum response factor-dependent target gene expressed preferentially in differentiated smooth muscle cells","volume":"287","author":"Nanda","year":"2012"},{"key":"10.1016\/j.neurol.2019.09.005_bib0130","doi-asserted-by":"crossref","first-page":"439","DOI":"10.1016\/j.jns.2016.10.008","article-title":"Nodding syndrome, other forms of epilepsy, and the Nakalanga syndrome most likely directly or indirectly caused by Onchocerca volvulus","volume":"372","author":"Colebunders","year":"2017","journal-title":"J Neurol Sci"},{"key":"10.1016\/j.neurol.2019.09.005_bib0135","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1016\/j.yebeh.2018.11.008","article-title":"Clinical presentations of onchocerciasis-associated epilepsy (OAE) in Cameroon","volume":"90","author":"Siewe","year":"2018","journal-title":"Epilepsy Behav"},{"key":"10.1016\/j.neurol.2019.09.005_bib0140","doi-asserted-by":"crossref","first-page":"1","DOI":"10.11604\/pamj.2017.28.1.13554","article-title":"Nodding syndrome (NS) and Onchocerca Volvulus (OV) in Northern Uganda","volume":"28","author":"Lagoro","year":"2017","journal-title":"Pan Afr Med J"},{"key":"10.1016\/j.neurol.2019.09.005_bib0145","doi-asserted-by":"crossref","first-page":"2441","DOI":"10.1093\/brain\/aww187","article-title":"Hyperphosphorylated tau in patients with refractory epilepsy correlates with cognitive decline: a study of temporal lobe resections","volume":"139","author":"Tai","year":"2016","journal-title":"Brain"},{"key":"10.1016\/j.neurol.2019.09.005_bib0150","first-page":"603","article-title":"Prevalence of nodding syndrome \u2013 Uganda, 2012\u20132013","volume":"63","author":"Iyengar","year":"2014","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"10.1016\/j.neurol.2019.09.005_bib0155","doi-asserted-by":"crossref","first-page":"e0006588","DOI":"10.1371\/journal.pntd.0006588","article-title":"A real-time medical cartography of epidemic disease (Nodding syndrome) using village-based lay mHealth reporters","volume":"12","author":"Valdes Angues","year":"2018","journal-title":"PLoS Negl Trop Dis"},{"key":"10.1016\/j.neurol.2019.09.005_bib0160","first-page":"7","article-title":"The Mabira forest","volume":"1","author":"Pitman","year":"1934","journal-title":"Uganda J"},{"key":"10.1016\/j.neurol.2019.09.005_bib0165","first-page":"339","article-title":"Endemic dwarfism in Uganda","author":"Raper","year":"1950","journal-title":"East Afr Med J"},{"key":"10.1016\/j.neurol.2019.09.005_bib0170","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1016\/0035-9203(61)90024-4","article-title":"Endocrine dysfunction in a Nakalanga dwarf","volume":"55","author":"Marshall","year":"1961","journal-title":"Trans Roy Soc Trop Med Hyg"},{"key":"10.1016\/j.neurol.2019.09.005_bib0175","first-page":"97","article-title":"Nakalanga, Notes on the endemic dwarfism of Uganda","volume":"14","author":"Jelliffe","year":"1962","journal-title":"Trop Geogr Med"},{"key":"10.1016\/j.neurol.2019.09.005_bib0180","first-page":"511","article-title":"A survey of Simulium control in Africa","volume":"27","author":"Brown","year":"1962","journal-title":"Bull WHO"},{"key":"10.1016\/j.neurol.2019.09.005_bib0185","series-title":"Onchocerciasis and epilepsy in Uganda, letter to the Lancet","first-page":"343","author":"Kipp","year":"1995"},{"key":"10.1016\/j.neurol.2019.09.005_bib0190","series-title":"Untersuchungen zur Genese und definition des Nakalanga-Syndroms (Investigations on the etiology and definition of the Nakalanga syndrome)","author":"H\u00f6fer","year":"1999"},{"key":"10.1016\/j.neurol.2019.09.005_bib0195","first-page":"554","article-title":"Epilepsy and retarded growth in a hyperendemic focus of onchocerciasis in rural western Uganda","volume":"69","author":"Ovuga","year":"1992","journal-title":"East Afr Med J"},{"key":"10.1016\/j.neurol.2019.09.005_bib0200","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1016\/j.trstmh.2006.06.003","article-title":"Mortality from epilepsy in an onchocerciasis-endemic area in West Uganda","volume":"101","author":"Kaiser","year":"2007","journal-title":"Trans R Soc Trop Med Hyg"},{"key":"10.1016\/j.neurol.2019.09.005_bib0205","doi-asserted-by":"crossref","first-page":"e006195","DOI":"10.1136\/bmjopen-2014-006195","article-title":"Nodding syndrome in Kitgum district, Uganda: association with conflict and displacement","volume":"4","author":"Landis","year":"2014","journal-title":"BMJ Open"},{"issue":"2","key":"10.1016\/j.neurol.2019.09.005_bib0210","doi-asserted-by":"crossref","first-page":"e0005201","DOI":"10.1371\/journal.pntd.0005201","article-title":"Nakalanga syndrome: clinical characteristics, potential causes, and its relationship with recently described Nodding syndrome","volume":"11","author":"F\u00f6ger","year":"2017","journal-title":"Plos Neg Trop Dis"},{"key":"10.1016\/j.neurol.2019.09.005_bib0215","first-page":"692","article-title":"Some biochemical observations in the Nakalanga","volume":"42","author":"Leonard","year":"1965","journal-title":"East Afr Med J"},{"key":"10.1016\/j.neurol.2019.09.005_bib0220","doi-asserted-by":"crossref","first-page":"525","DOI":"10.1016\/S0035-9203(97)90009-2","article-title":"Epilepsy, retarded growth and onchocerciasis, in two areas of different endemicity of onchocerciasis in Burundi","volume":"91","author":"Newell","year":"1997","journal-title":"Trans R Soc Trop Med Hyg"},{"key":"10.1016\/j.neurol.2019.09.005_bib0225","year":"2011"},{"key":"10.1016\/j.neurol.2019.09.005_bib0230","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1016\/j.brainresbull.2018.08.024","article-title":"Neurological manifestations in Onchocerca volvulus infection: a review","volume":"145","author":"Hotterbeekx","year":"2019","journal-title":"Brain Res Bull"},{"key":"10.1016\/j.neurol.2019.09.005_bib0235","first-page":"11","article-title":"El sindrome epileptico y sus relaciones con la Oncocercosis","volume":"1","author":"Casis Sacre","year":"1938","journal-title":"Bol Salub Hig (Mexico)"},{"key":"10.1016\/j.neurol.2019.09.005_bib0240","first-page":"22","article-title":"Epilepsy and onchocerciasis: pioneering research of Mexican physicians vindicated","volume":"4","author":"Jilek-Aall","year":"2004","journal-title":"Invest Salud (Mexico)"}],"container-title":["Revue Neurologique"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0035378719306733?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0035378719306733?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,9,22]],"date-time":"2025-09-22T05:40:03Z","timestamp":1758519603000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0035378719306733"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,12]]},"references-count":48,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2019,12]]}},"alternative-id":["S0035378719306733"],"URL":"https:\/\/doi.org\/10.1016\/j.neurol.2019.09.005","relation":{},"ISSN":["0035-3787"],"issn-type":[{"value":"0035-3787","type":"print"}],"subject":[],"published":{"date-parts":[[2019,12]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Nodding syndrome phenotypes","name":"articletitle","label":"Article Title"},{"value":"Revue Neurologique","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.neurol.2019.09.005","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2019 The Authors. Published by Elsevier Masson SAS.","name":"copyright","label":"Copyright"}]}}