Nodding syndrome, a rare form of epilepsy that has affected thousands of children aged 5 to 15 in East Africa, may be caused by an inappropriate immune response to the parasitic worm Onchocerca volvulus, which causes onchocerciasis (river blindness).
Since its discovery in Tanzania in the 1960s, nodding syndrome has remained an incurable condition marked by seizures, neurodegeneration, and a high mortality rate. The increase in nodding syndrome in areas where the parasite O volvulus is prevalent indicates that infection with the worm is involved in the etiology of the illness.