University of Khartoum

An Epidemic of Seizures and Psychosis in a Sudanese Village

An Epidemic of Seizures and Psychosis in a Sudanese Village

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Title: An Epidemic of Seizures and Psychosis in a Sudanese Village
Author: Seidi, Osheik Abu’Asha; Abdelmotaal, E.M.; El Karsani, M.; Bushara, I.; El Tahir, S.; Al Mahjoub, A.; Mohamed, A.A.; Abu Aisha, H.H.
Abstract: In January 2010 a wave of pathological laughter, crying, seizures and bizarre behavior affected about 122 people in a remote village in the far North West State of Kordofan in Sudan. Our team underwent detailed investigations of the clinical presentations and possible underlying causes and provided medical treatment as well. Children constituted 52% and were more severely affected than adults. The main presentations were visual hallucinations, uncontrolled laugher, twisting movements, delirium, and convulsions. No vascular manifestations were detected. Males were affected more than females (60%). In a few of the severely affected patients a lumbar puncture was performed (7/122).The patients were treated symptomatically with benzodiazepines. Carbamazepine was used in those presenting with recurrent seizures. Routine urine, blood and CSF basic parameters were all within normal limits for routines, but the toxicology screen of urine missed the critical period for detection of the suspected toxic substances. Samples from the water sources were clear, but the wheat consumed by the villagers grew the fungus Claviceps purpurea in abundance. Further tests on the fungi revealed their production of very high level of LSD- like ergot alkaloids. No long term neurological sequalae noticed on follow up The wheat came from stores in Darfur which is near the affected village . The epidemic was contained and a public education campaign was launched to avoid recurrence of the event . This study draws attention to the importance of vigilance about neurotoxins as causes of bizarre presentations.
URI: http://khartoumspace.uofk.edu/handle/123456789/19619
Date: 2015


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