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Table 2 Proposed clinical case definition for “onchocerciasis associated epilepsy” (“river epilepsy”)

From: Nodding syndrome and epilepsy in onchocerciasis endemic regions: comparing preliminary observations from South Sudan and the Democratic Republic of the Congo with data from Uganda

Major criteria
 A previously healthy person in an onchocerciasis endemic area who develops head-nodding or convulsive epilepsy of unknown etiology between the ages 3 and 18
 Plus at least one of the following:
Minor criteria
 Other neurological abnormalities (cognitive decline, school dropout due to cognitive/behavioral problems, psychiatric manifestations, other neurological abnormalities)
 Clustering in space or time with similar cases
 Stunting or wasting
 Delayed sexual development