Table 1.

Proposed case definitions for nodding syndrome (WHO, 2012)

Suspected case:     (Used at the community level, primarily by marginally trained health teams when asking the mother/caretaker.) Reported head nodding in a previously normal person. Head nodding is defined as repetitive, involuntary drops of the head to the chest on two or more occasions.

Probable case: suspect case of head nodding with: Both of the following major criteria: Age at onset of nodding between 3 and 18 years old Frequency of nodding 5–20 per minute Plus at least one of the following minor criteria: Other neurological abnormalities (cognitive decline, school dropout due to cognitive/behavioural problems, other seizures or neurological abnormalities) Clustering in space or time with similar cases Triggered by food and/or cold weather Stunting or wasting Delayed sexual or physical development Psychiatric symptoms.

Confirmed case: is a probable case Plus a documented nodding episode that is: Observed by trained healthcare worker, or Videotaped, or EEG/EMG

ReproducedwithpermissionfromtheWHO.