title: The role of Onchocerca volvulus in the development of epilepsy in a rural area of Tanzania.
abstract: 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.
authors.affiliation: Department of Neurology, Innsbruck Medical University, Anichstrasse 35, 6020 Innsbruck, Austria.
authors.forename: Rebekka
authors.initials: R
authors.lastname: König
authors.forename: Amir
authors.initials: A
authors.lastname: Nassri
authors.forename: Michael
authors.initials: M
authors.lastname: Meindl
authors.forename: William
authors.initials: W
authors.lastname: Matuja
authors.forename: Aslam R
authors.initials: AR
authors.lastname: Kidunda
authors.forename: Vera
authors.initials: V
authors.lastname: Siegmund
authors.forename: Gisela
authors.initials: G
authors.lastname: Bretzel
authors.forename: Thomas
authors.initials: T
authors.lastname: Löscher
authors.forename: Louise
authors.initials: L
authors.lastname: Jilek-Aall
authors.forename: Erich
authors.initials: E
authors.lastname: Schmutzhard
authors.forename: Andrea Sylvia
authors.initials: AS
authors.lastname: Winkler
mesh_terms: 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
chemical_list: D000909:Antibodies, Helminth; D007074:Immunoglobulin G