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The role of Onchocerca volvulus in the development of epilepsy in a rural area of Tanzania

Published online by Cambridge University Press:  14 April 2010

REBEKKA KÖNIG ,
AMIR NASSRI ,
MICHAEL MEINDL ,
WILLIAM MATUJA ,
ASLAM R. KIDUNDA ,
VERA SIEGMUND ,
GISELA BRETZEL ,
THOMAS LÖSCHER ,
LOUISE JILEK-AALL  and
ERICH SCHMUTZHARD
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REBEKKA KÖNIG
Affiliation:
Department of Neurology, Innsbruck Medical University, Anichstraße 35, 6020 Innsbruck, Austria Department of Infectious Diseases & Tropical Medicine, Ludwig-Maximilians-University, Leopoldstraße 5, 80802 Munich, Germany
AMIR NASSRI
Affiliation:
Department of Neurology, Innsbruck Medical University, Anichstraße 35, 6020 Innsbruck, Austria
MICHAEL MEINDL
Affiliation:
Department of Neurology, Innsbruck Medical University, Anichstraße 35, 6020 Innsbruck, Austria
WILLIAM MATUJA
Affiliation:
Department of Neurology, Muhimbili University of Health and Allied Sciences, P.O. Box 65001, Dar es Salaam, Tanzania
ASLAM R. KIDUNDA
Affiliation:
Mahenge District Hospital, Mahenge, Ulanga District, Morogoro Region, Tanzania
VERA SIEGMUND
Affiliation:
Department of Infectious Diseases & Tropical Medicine, Ludwig-Maximilians-University, Leopoldstraße 5, 80802 Munich, Germany
GISELA BRETZEL
Affiliation:
Department of Infectious Diseases & Tropical Medicine, Ludwig-Maximilians-University, Leopoldstraße 5, 80802 Munich, Germany
THOMAS LÖSCHER
Affiliation:
Department of Infectious Diseases & Tropical Medicine, Ludwig-Maximilians-University, Leopoldstraße 5, 80802 Munich, Germany
LOUISE JILEK-AALL
Affiliation:
571 English Bluff Road, Delta, BC V4M 2M9, Canada
ERICH SCHMUTZHARD
Affiliation:
Department of Neurology, Innsbruck Medical University, Anichstraße 35, 6020 Innsbruck, Austria
ANDREA SYLVIA WINKLER*
Affiliation:
Interdisciplinary Centre for Palliative Medicine and Department of Neurology, Ludwig-Maximilians-University, Marchioninistraße 15, 81377 Munich, Germany
*
*Corresponding author: Interdisciplinary Centre for Palliative Care and Department of Neurology, Marchioninistrasse 15, 81377 Munich, Germany. Tel: +49 89 142097. Fax: +49 89 14337947. E-mail: drawinkler@yahoo.com.au
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Summary

Introduction. 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. Discussion. 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.

Keywords

onchocerciasisepilepsyTanzaniaintrathecal antibodiesOnchocerca volvulus
Type
Research Article
Information
Parasitology , Volume 137 , Issue 10 , September 2010 , pp. 1559 - 1568
Copyright
Copyright © Cambridge University Press 2010

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