The role of Onchocerca volvulus in the development of epilepsy in a rural area of Tanzania.
BACKGROUND
Several reports indicate high prevalences of both onchocerciasis and epilepsy in some regions of Africa. This raises the question of whether these diseases are associated. We therefore investigated people with epilepsy and/or onchocerciasis living in an area in Tanzania endemic for Onchocerca volvulus (O. volvulus).


METHODS
We collected clinical information, skin snips, and blood from 300 individuals, and cerebrospinal fluid (CSF) from 197. Participants were allocated to 4 groups consisting of people with epilepsy and onchocerciasis (n=135), those with either epilepsy (n=61) or onchocerciasis only (n=35), and healthy individuals (n=69). Samples were evaluated for microfilaria, IgG4 antibodies against O. volvulus, O. volvulus antibody index (CSF/serum), and CSF routine parameters. Polymerase chain reaction (PCR) was performed on skin snips and CSF.


RESULTS
No difference was found in microfilarial density between participants with and without epilepsy (P=0.498). The antibody index was raised in 2 participants. CSF PCR was negative in all samples tested.


CONCLUSIONS
Our results do not give evidence of a relationship between O. volvulus and epilepsy. Despite the fact that 2 participants had raised antibody index, the existence of cerebral onchocerciasis caused by migration of microfilariae into the CSF appears unlikely. However, to date unexplored reactions to the infestation with O. volvulus causing epilepsy cannot be excluded.
König
Rebekka
R
Department of Neurology, Innsbruck Medical University, Anichstrasse 35, 6020 Innsbruck, Austria.
Nassri
Amir
A
Meindl
Michael
M
Matuja
William
W
Kidunda
Aslam R
AR
Siegmund
Vera
V
Bretzel
Gisela
G
Löscher
Thomas
T
Jilek-Aall
Louise
L
Schmutzhard
Erich
E
Winkler
Andrea Sylvia
AS
D000293:Adolescent; D000328:Adult; D000368:Aged; D000818:Animals; D000909:Antibodies, Helminth / Q000097:blood; D001769:Blood / Q000469:parasitology; D002555:Cerebrospinal Fluid / Q000469:parasitology; D002648:Child; D004827:Epilepsy / Q000175:diagnosis / Q000453:epidemiology* / Q000469:parasitology; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D008297:Male; D008842:Microfilariae / Q000276:immunology / Q000302:isolation & purification; D008875:Middle Aged; D017181:Onchocerca volvulus / Q000276:immunology / Q000302:isolation & purification*; D009855:Onchocerciasis / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology* / Q000469:parasitology; D015995:Prevalence; D012424:Rural Population / Q000706:statistics & numerical data*; D012867:Skin / Q000469:parasitology; D013636:Tanzania / Q000453:epidemiology; D055815:Young Adult
D000909:Antibodies, Helminth; D007074:Immunoglobulin G