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Purpose: [ 18 F]PI-2620 positron emission tomography (PET) detects misfolded tau in progressive supranuclear palsy (PSP) and Alzheimer's disease (AD). We questioned the feasibility and value of absolute [ 18 F]PI-2620 PET quantification for assessing tau by regional distribution volumes (V T ). Here, arterial input functions (AIF) represent the gold standard, but cannot be applied in routine clinical practice, whereas image-derived input functions (IDIF) represent a non-invasive alternative. We aimed to validate IDIF against AIF and we evaluated the potential to discriminate patients with PSP and AD from healthy controls by non-invasive quantification of [ 18 F] PET., Methods: In the first part of the study, we validated AIF derived from radial artery whole blood against IDIF by investigating 20 subjects (ten controls and ten patients). IDIF were generated by manual extraction of the carotid artery using the average and the five highest (max5) voxel intensity values and by automated extraction of the carotid artery using the average and the maximum voxel intensity value. In the second part of the study, IDIF quantification using the IDIF with the closest match to the AIF was transferred to group comparison of a large independent cohort of 40 subjects (15 healthy controls, 15 PSP patients and 10 AD patients). We compared V T and V T ratios, both calculated by Logan plots, with distribution volume (DV) ratios using simplified reference tissue modelling and standardized uptake value (SUV) ratios., Results: AIF and IDIF showed highly correlated input curves for all applied IDIF extraction methods (0.78 < r < 0.83, all p < 0.0001; area under the curves (AUC): 0.73 < r ≤ 0.82, all p ≤ 0.0003). Regarding the V T values, correlations were mainly found between those generated by the AIF and by the IDIF methods using the maximum voxel intensity values. Lowest relative differences (RD) were observed by applying the manual method using the five highest voxel intensity values (max5) (AIF vs. IDIF manual, avg: RD = -82%; AIF vs. IDIF automated, avg: RD = -86%; AIF vs. IDIF manual, max5: RD = -6%; AIF vs. IDIF automated, max: RD = -26%). Regional V T values revealed considerable variance at group level, which was strongly reduced upon scaling by the inferior cerebellum. The resulting V T ratio values were adequate to detect group differences between patients with PSP or AD and healthy controls (HC) (PSP target region (globus pallidus): HC vs. PSP vs. AD: 1.18 vs. 1.32 vs. 1.16; AD target region (Braak region I): HC vs. PSP vs. AD: 1.00 vs. 1.00 vs. 1.22). V T ratios and DV ratios outperformed SUV ratios and V T in detecting differences between PSP and healthy controls, whereas all quantification approaches performed similarly in comparing AD and healthy controls., Conclusion: Blood-free IDIF is a promising approach for quantification of [ 18 F]PI-2620 PET, serving as correlating surrogate for invasive continuous arterial blood sampling. Regional [ 18 F]PI-2620 V T show large variance, in contrast to regional [ 18 F]PI-2620 V T ratios scaled with the inferior cerebellum, which are appropriate for discriminating PSP, AD and healthy controls. DV ratios obtained by simplified reference tissue modeling are similarly suitable for this purpose., (© 2024. The Author(s).)

Background: Family group conferences (FGCs) in child welfare bring immediate and wider family members together to decide on the best way to meet a child's needs. Unlike professionally led meetings, the aim is for decisions to be made by or with family members. Qualitative and mixed-method research with FGC participants tends to show positive experiences: most participants feel their voices are heard; FGCs facilitate family-driven solutions and closer relationships-within families and with social workers. Although there is existing literature on FGCs, there is a paucity of robust comparative UK evaluations, i.e., randomised controlled trials or quasi-experimental studies. Comparative studies internationally have focused on a narrow range of outcomes, not recognised the importance of context, and paid little attention to the quality of delivery. Some qualitative studies have considered process and context but there is scant measurement of these. The aims of this study are, firstly, to establish how FGCs improve outcomes for families and what factors vary their quality, and, secondly, to assess longer-term outcomes in terms of service use and associated costs., Methods: Given the importance of process and context, evaluation informed by realist and complex systems approaches is needed. This multi-method evaluation includes a survey of FGC services in all UK local authorities (n = 212) to map service provision; co-design of programme theory and evaluation measures with family members who have experienced an FGC (n = 16-24) and practitioners (n = 16-24) in two sites; a prospective single-arm study of FGC variability and outcomes after six months; and comparison of service use and costs in FGC participants (n≥300 families) and a control group (n≥1000) after two years using a quasi-experiment., Discussion: This is a pragmatic evaluation of an existing intervention, to identify what mechanisms and contexts influence effective process and longer-term outcomes. The study is registered with Research Registry (ref. 7432)., Competing Interests: Jonathan Scourfield is a trustee of the Family Rights Group, a charity that promotes better family participation in the child welfare process, and family group conferences as one way of achieving this. This non-financial interest does not alter our adherence to PLOS ONE policies on sharing data and materials, with the provisos in the data sharing statement., (Copyright: © 2024 Scourfield et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

3D documentation in forensics and forensic medicine is being introduced more frequently in various institutes around the world. However, several institutes lack capacity in finances as well as staff to perform 3D documentations regularly. This technical paper aims to present a 3D documentation device that is low cost and easy to use and is a viable entry level solution for forensic medical departments. For this the small single-board computer Raspberry Pi 4 was used in conjunction with its high quality (HQ) camera module to create the 3DLamp - a flexible, low cost and easy to use documentation device. Besides a detailed description of the device this paper also presents four case examples where a 3D documentation was performed and analyses the acquired data and the created 3D models. It was found that the device returns feasible 3D models that appear usable for forensic 3D reconstructions., Competing Interests: Declaration of Competing Interest The Austrian Center for Medical Innovation and Technology (ACMIT GmbH), developed the 3DLamp system in collaboration with the Institute of Forensic Medicine, University of Zurich. In case of commercialisation both, the University of Zürich and ACMIT GmbH might declare commercial interest in the product and its sales., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

Purpose: A reliable method for regional in vivo imaging of radiation-induced cellular damage would be of great importance for the detection of therapy-induced injury to healthy tissue and the choice of adequate treatment of radiation emergency patients in both civilian and military events. This study aimed to investigate in a mouse model if positron emission tomography (PET) imaging with proliferation and apoptosis markers is potentially suitable for this purpose., Methods: Four groups, including twenty mice (wild-type C57BL/6) each, were whole-body irradiated with 0 Gy, 0.5 Gy, 1 Gy, and 3 Gy and examined by PET over a six-month period at defined time points. 3'-[ 18 F]fluoro-3'-deoxythymidine ([ 18 F]FLT) and 2-(5-[ 18 F]fluoropentyl)-2-methyl malonic acid ([ 18 F]ML-10) were used to visualise proliferation and apoptosis. Regional standard uptake values were compared with respect to irradiation dose over time. Histologic data and peripheral blood cell values were correlated with the PET results., Results: The hematopoietic bone marrow showed a significantly increased [ 18 F]FLT signal at early time points after radiation exposure (day 3 and day 7). This correlated with blood parameters, especially leukocytes, and histological data. A significantly increased [ 18 F]FLT signal also occurred in the gastrointestinal tract and thymus at early time points. An increased [ 18 F]ML-10 signal related to irradiation doses was observed in the bone marrow on day 8, but there was a high variability of standard uptake values and no correlation with histological data., Conclusion: [ 18 F]FLT showed potential to visualise the extent, regional distribution and recovery from radiation-induced cellular damage in the bone marrow, gastrointestinal tract and thymus. The potential of [ 18 F]FLT imaging to assess the extent of bone marrow affected by irradiation might be especially useful to predict the subsequent severity of hematopoietic impairment and to adapt the therapy of the bone marrow reserve. [ 18 F]ML-10 PET proved to be not sensitive enough for the reliable detection of radiation induced apoptosis., (© 2023. The Author(s).)

Since early 2020, the world has been dealing with the COVID-19 pandemic. The rapid changing situation led to unforeseeable challenges and questions for many people, including pregnant women. Through a textual analysis of personal narratives told via pregnancy and/or laboring vlogs during COVID-19, this present study aims to understand how women from China who live in another country during pregnancy have utilized YouTube vlogs to share their experiences. Through this analysis, we identify various challenges that these women experienced during their pregnancy. The COVID-19 pandemic exaggerated the normal difficulties of these issues and also created additional problems for these women, including regular pregnancy tests, choice of birthing locations, and the support and caring that were normal during this time period., Competing Interests: The authors have no relevant financial interest or affiliations with any commercial interests related to the subjects discussed within this article., (© Copyright 2023 Lamaze International.)

This work addresses the problem of reference tracking in autonomously learning robots with unknown, nonlinear dynamics. Existing solutions require model information or extensive parameter tuning, and have rarely been validated in real-world experiments. We propose a learning control scheme that learns to approximate the unknown dynamics by a Gaussian Process (GP), which is used to optimize and apply a feedforward control input on each trial. Unlike existing approaches, the proposed method neither requires knowledge of the system states and their dynamics nor knowledge of an effective feedback control structure. All algorithm parameters are chosen automatically, i.e. the learning method works plug and play. The proposed method is validated in extensive simulations and real-world experiments. In contrast to most existing work, we study learning dynamics for more than one motion task as well as the robustness of performance across a large range of learning parameters. The method's plug and play applicability is demonstrated by experiments with a balancing robot, in which the proposed method rapidly learns to track the desired output. Due to its model-agnostic and plug and play properties, the proposed method is expected to have high potential for application to a large class of reference tracking problems in systems with unknown, nonlinear dynamics., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Meindl, Lehmann and Seel.)

Identifying which approaches can effectively reduce the need for out-of-home care for children is critically important. Despite the proliferation of different interventions and approaches globally, evidence summaries on this topic are limited. This study is a scoping review using a realist framework to explore what research evidence exists about reducing the number of children and young people in care. Searches of databases and websites were used to identify studies evaluating intervention effect on at least one of the following outcomes: reduction in initial entry to care; increase in family reunification post care. Data extracted from papers included type of study, outcome, type and level of intervention, effect, mechanism and moderator, implementation issues and economic (EMMIE) considerations. Data were coded by: primary outcome; level of intervention (community, policy, organisation, family or child); and type of evidence, using the realist EMMIE framework. This is the first example of a scoping review on any topic using this framework. Evaluated interventions were grouped and analysed according to system-level mechanism. We present the spread of evidence across system-level mechanisms and an overview of how each system-level mechanism might reduce the number of children in care. Implications and gaps are identified., (© The Author(s) 2021. Published by Oxford University Press on behalf of The British Association of Social Workers.)

At many portals of entry the relative uptake by phagocytes and non-phagocytic cells has a prominent effect on availability and biological action of nanoparticles (NPs). Cellular uptake can be determined for fluorescence-labeled NPs. The present study compares three methods (plate reader, flow cytometry and image analysis) in order to investigate the influence of particle size and functionalization and medium content on cellular uptake of fluorescence-labeled polystyrene particles and to study the respective method́s suitability for uptake studies. For comparison between the techniques, ratios of macrophage to alveolar epithelial cell uptakes were used. Presence of serum protein in the exposure solution decreased uptake of carboxyl-functionalized and non-functionalized particles; there was no clear effect for the amine-functionalized particles. The 200nm non- or carboxyl-functionalized NPs were taken up preferentially by phagocytes while for amine-functionalized particles preference was lowest. The presence of the serum slightly increased the preference for these particles. In conclusion, due to the possibility of calibration, plate reader measurements might present a better option than the other techniques to (semi)quantify differences between phagocytes and non-phagocytic cells for particles with different fluorescence. In order to obtain unbiased data the fluorescent labeling has to fulfill certain requirements., (Copyright © 2017 The Author(s). Published by Elsevier B.V. All rights reserved.)

Background: The prevalence of febrile seizures (FSs) and epilepsy are often reported to be higher in sub-Saharan Africa. Furthermore, several studies describe complex features of FSs as risk factors for the development of subsequent epilepsy., Methods: During the period from 2002 to 2004 door-to-door studies with supplementary data collection were conducted in three different areas of Tanzania, examining the prevalence of FSs in 7,790 children between the age of 2 mo and 7 y at the time of the interview. The information on the presence of FSs of 14,583 children, who at the time of the interview were younger than 15 y, was collected in order to describe reported seizures, if any., Results: Overall, 160 children between 2 mo and 7 y with a prevalence rate of 20.5/1,000 (95% confidence interval: 17.5-23.9/1,000) met the criteria for FSs. The average age at onset was 2.2 (SD: 1.8) y and ~42% had complex FSs. Respiratory tract infections and malaria were the most frequent concomitant diseases., Conclusion: Our findings do not confirm the assumption of an increased prevalence of FSs in sub-Saharan Africa. However, the elevated number of complex FSs emphasizes the necessity of more reliable studies about FSs and its consequences.

Background: Primary Care reform in Canada and globally has encouraged the development of interprofessional primary care initiatives. This has led to significant involvement of non-physician Health Care Providers (NPHCPs) in the teaching of medical trainees. The objective of this study was to understand the experiences, supports and challenges facing non-physician health care providers in Family Medicine education., Methods: Four focus groups were conducted using a semi-structured interview guide with twenty one NPHCPs involved in teaching at the University of Toronto, Department of Family & Community Medicine. The focus groups were transcribed and analyzed for recurrent themes. The multi-disciplinary research team held several meetings to discuss themes., Results: NPHCPs were highly involved in Family Medicine education, formally and informally. NPHCPs felt valued as teachers, but this often did not occur until after learners understood their educator role through increased time and exposure. NPHCPs expressed a lack of advance information of learner knowledge level and expectations, and missed opportunities to give feedback or receive teaching evaluations. Adequate preparation time, teaching space and financial compensation were important to NPHCPs, yet were often lacking. There was low awareness but high interest in faculty status and professional development opportunities., Conclusions: Sharing learner goals and objectives and offering NPHCPs feedback and evaluation would help to formalize NPHCP roles and optimize their capacity for cross-professional teaching. Preparation time and dedicated space for teaching are also necessary. NPHCPs should be encouraged to pursue faculty appointments and to access ongoing Professional Development opportunities.

Background: Onchocerciasis has been implicated in the pathogenesis of epilepsy. The debate on a potential causal relationship between Onchocerca volvulus and epilepsy has taken a new direction in the light of the most recent epidemic of nodding syndrome., Objective: To document MRI changes in people with different types of epilepsy and investigate whether there is an association with O. volvulus infection., Methods: In a prospective study in southern Tanzania, an area endemic for O. volvulus with a high prevalence of epilepsy and nodding syndrome, we performed MRI on 32 people with epilepsy, 12 of which suffered from nodding syndrome. Polymerase chain reaction (PCR) of O. volvulus was performed in skin and CSF., Results: The most frequent abnormalities seen on MRI was atrophy (twelve patients (37.5%)) followed by intraparenchymal pathologies such as changes in the hippocampus (nine patients (28.1%)), gliotic lesions (six patients (18.8%)) and subcortical signal abnormalities (three patients (9.4%)). There was an overall trend towards an association of intraparenchymal cerebral pathologies and infection with O. volvulus based on skin PCR (Fisher's Exact Test p=0.067) which was most pronounced in children and adolescents with nodding syndrome compared to those with other types of epilepsy (Fisher's Exact Test, p=0.083). Contrary to skin PCR results, PCR of CSF was negative in all patients., Conclusion: The observed trend towards an association of intraparenchymal cerebral pathological results on MRI and a positive skin PCR for O. volvulus despite negative PCR of CSF is intriguing and deserves further attention.

Background: Bariatric surgery is the most effective treatment to reduce weight permanently which is essential to avoid, to improve or even to cure life-threatening comorbidities. Little is known about changes of the psychological etiology and risk factors., Methods: The present study concentrated on psychological variables which are considered to cause or promote obesity. The changes of symptoms were measured by the AD-EVA test inventory. A total of 60 patients (24 male/36 female, age 18-71 years) were tested prior to gastric bypass or gastric banding (body mass index BMI M=44.95, SD=6.91) and postoperatively (BMI M=33.92, SD=7.23)., Results: Following surgery the variables addiction (t=11.15, p<0.01) and binge eating disorder (t=2.13, p<0.05) showed significant changes across all patients and therefore confirmed a positive effect but restrained eating and bulimia remained unmodified after surgery. There were significant differences between the two bariatric methods (p<0.01)., Discussion: A precise interdisciplinary evaluation is a prerequisite for deciding between gastric banding and the bypass technique as well as to define the need for preoperative and postoperative psychotherapy.

Objective: One goal of the campaign "Lifting the burden: The global campaign against headache" is to highlight existing evidence about headache worldwide. In this context, the aim of our study was to report the migraine-related headache burden in northern Tanzania., Methods: From December 2003 until June 2004 a community-based door-to-door survey was undertaken in northern Tanzania, using multistage cluster sampling. Based on the criteria of the International Headache Society, 7412 individuals were enrolled in this survey., Results: Migraine patients' average annual attack frequency was 18.4 (n = 308, standard deviation [SD] ± 47.4) with a mean duration of 16.4 hours (SD ± 20.6). The average headache intensity per patient was 2.65 (SD ± 0.59) with a calculated loss of 6.59 (SD ± 26.7) working days per year. Extrapolation of data to the investigated population (n = 7412) resulted in annual migraine burden of 281.0 migraine days per 1000 inhabitants., Conclusions: To our knowledge, this study reports for the first time the burden that arises from migraine headache in a rural population of sub-Sahara Africa (SSA). As the presented migraine-related burden is considerable, we hope that our data will increase the awareness among local decision makers in allocating resources for treatment and research on headache., (© 2011 American Headache Society.)

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.

We have previously described a seizure disorder characterized by head nodding (HN). In a prospective study in southern Tanzania, we evaluated 62 patients with HN. Here, we report the patients' clinical characteristics and those of their seizures, which indicate high seizure frequency, unsatisfactory seizure control, a high burden of cognitive impairment and disease-associated barriers to education.

Our aim was to assess the 1-year prevalence of migraine headache in a rural population within the catchment area of the Haydom Lutheran Hospital in northern Tanzania. From December 2003 until June 2004 a community-based door-to-door survey was carried out, using a questionnaire based on the criteria of the International Headache Society, including 1192 households with 7412 individuals selected by multistage cluster-random sampling. The overall 1-year prevalence of migraine headache was found to be 4.3% [316/7412, 95% confidence interval (CI) 3.8, 4.7] with an age-adjusted rate of 6.0% and a male : female ratio of 1:2.94 (P < 0.001). Of these individuals, 132 did not fulfil all criteria for migraine headache, hence, these patients had to be classified as migrainous disorders with a crude prevalence rate of 1.8% (132/7412. 95% CI 1.5, 2.1). The remaining 184 patients met all criteria for migraine resulting in a 1-year prevalence of 2.5% (184/7412, 95% CI 2.1, 2.9) and a male : female ratio of 1:2.51 (P < 0.001). The present survey shows that migraine headache is not uncommon in northern Tanzania. The recorded prevalence of migraine headache is located within the median of previous African prevalence surveys, which confirms the trend of lower migraine frequencies in rural Africa compared with western countries.

The prevalence of Parkinson's disease (PD) in sub-Saharan Africa is still a matter of debate. The few studies that have been conducted have shown prevalences lower than those in the western world. Whether this represents a genuine finding is unclear to date. In northern Tanzania, we have conducted a hospital-based evaluation and a community-based door-to-door study to assess the prevalence of Parkinsonism, including that of PD. Over a period of 8 months, all patients admitted to a mid-size rural hospital were screened for PD. In parallel, 1,569 people aged >or=50 years were recruited from the communities and assessed for PD with standard questions. Sampling was performed according to the method of "multistage cluster sampling." The questions had previously been tested in a pilot study prior to the survey. People who screened positive were examined by a specialist neurologist. In the hospital, eight of 740 people with neurological diagnoses had Parkinsonism, of whom three patients had a diagnosis of PD. In the community-based study, 18 people answered positively to least one of the 12 screening questions. However, the diagnosis of PD could not be confirmed by further examination in any of them. The prevalence of PD in northern Tanzania was found to be very low. This result would need confirmation in studies with larger populations, ideally of different African ethnicities.

Restless legs syndrome (RLS) is a highly prevalent movement disorder. However, prevalences seem to vary amongst different ethnicities. To date, no community-based prevalence studies on RLS have been reported from the African continent. We have conducted a community-based, door-to-door study in northern Tanzania. Over a period of 16 months, 7,654 people aged 14 years and older were screened for the RLS Essential Diagnostic Criteria. Sampling was performed according to the method of "multistage cluster sampling." People who screened positive where reinterviewed and physically examined by a specialist neurologist. During the screening phase, 10 people answered "yes" to at least one of the screening questions. After reinterviewing those people, the result was confirmed in five people only. After careful re-evaluation of the results, only one person was diagnosed with RLS. Because of methodological limitations a definite prevalence may only be calculated from larger population-based studies of different African ethnicities with screening questions adapted to the cultural context., ((c) 2010 Movement Disorder Society.)

The aim of the study was to assess the prevalence of headache with special attention to tension-type headache (TTH) in a rural area in northern Tanzania. A door-to-door study was performed using a standardized and validated questionnaire. A total of 7412 participants were screened. The total headache prevalence during the past year was 12.1%; the overall 1-year prevalence of TTH was 7%; 5% reported episodic TTH and 0.4% chronic TTH. Borderline cases (International Headache Society code 2.3) were described in 1.6%. The prevalence of headache was highest in the 41-50-year-old group in women and in the 61+ age group in men. This is the first account of the prevalence of TTH in a rural Tanzanian population, and shows that headache in general and, more specifically, TTH are prevalent disorders that deserve attention. However, the prevalence of primary headache seems to be lower than in Western countries.

Purpose: The main aim of this door-to-door-study was to determine the prevalence, incidence, and clinical characteristics of epilepsy in northern Tanzania., Methods: A total of 7,399 people were screened with a standardized questionnaire using "multistage random sampling.", Results: The prevalence rate of epilepsy was 11.2/1,000 [95% confidence interval (CI) 8.9-13.9/1,000] and the age-adjusted prevalence rate was 13.2/1,000. The prevalence of active epilepsy was 8.7/1,000 (95% CI 6.7-11/1,000). There was a preponderance of women. The average retrospective incidence including the last 5 years was 81.1/100,000 (95% CI 65-101/100,000). Fifty-four percent (45 of 83) of the people with epilepsy had generalized seizures without any identifiable cause; 71% (59 of 83) of the epilepsy patients had not visited health institutions prior to the study and 76% (63 of 83) had never received treatment., Discussion: Our study shows that the prevalence and incidence of epilepsy in northern Tanzania are higher compared to developed countries and that the majority of people with epilepsy do not access treatment.

Purpose: In the 1960s in Tanzania, L. Jilek-Aall observed a seizure disorder characterized by head nodding (HN). Decades later, "nodding disease," reminiscent of what was seen in Tanzania, was reported from Sudan. To date this seizure disorder has not been classified and possible causes still remain obscure., Methods: In a prospective study in southern Tanzania, we evaluated 62 patients with HN. Selected patients underwent blood (n = 51) and cerebrospinal fluid (CSF) (n = 48) analyses. Others were chosen for MRI (n = 12) and EEG (n = 10)., Results: Seizure type was classified as "head nodding only" and "head nodding plus," the latter being combined with other types of seizure (n =34). During HN, consciousness was impaired in 11 patients (17.7%) and supportive signs of epileptic seizures were described by 15 (24.2%) patients. Precipitating factors were confirmed by 11 (17.7%) patients. Fifty-six (90.3%) patients had at least one relative with epilepsy. EEG confirmed interictal epileptic activity in two patients and unspecific changes in four patients. MRI showed hippocampus pathologies (n = 5) and gliotic changes (n = 5). Skin polymerase chain reaction (PCR) positivity for Onchocerca volvulus was significantly associated with lesions on MRI. However, PCR of the CSF was negative in all cases., Conclusions: We present a comprehensive clinical description of the "HN syndrome," possibly a new epilepsy disorder in sub-Saharan Africa. MRI lesions and their association with positive skin PCR for O. volvulus despite negative PCR of the CSF is intriguing and deserves attention. Furthermore, the high prevalence of hippocampus sclerosis and familial clustering of epilepsy may point toward other potential pathogenetic mechanisms.