Abstract Details

A wave wave of pathological laughter, seizures, crying and bizarre behavior affected about  a remote village in the far North West State of Kordofan , near Northern Darfur in Sudan.

The authorities and local community were puzzled

A team and a plan were set up urgently and travelled to the area.

Described the clinical presentations, investigations for the possible cause of an epidemic of seizures and bizarre behavior and movements in a remote village in Western Sudan, near 

Identify the underlying cause for this epidemic

This is a field survey using direct history taking , clinical examination, home and other sites visits as well as clinical managements and laboratory investigations.

All examined clinically , demographic and clinical  data were collected.  Blood,  urine and CSF  samples were collected. Data analyzed with SPSS statistical package.

122 patients identified. 49 were females (40%). Mean age was 19.9   SD 13.45 .

Children  constituted 56% and were more severely affected . Males were affected more than females (60%). The main presentations were visual hallucinations, uncontrolled laugher, twisting movements, delirium, and convulsions.

Routine  CSF results  (7/122) were normal but Microbiological testing was not feasible. 

 Samples from the water sources (5)  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.

The patients responded to  symptomatic treatments.

 No long term neurological sequalae noticed on follow up.

It is important to keep vigil on possible toxic causes when confronted with acute, large scale neurological presentations.

Pubic education  and training of local nurses, health worker and community leaders can effectively act as a surveillance and early  intervention mean in resource limited environment.

We call for collaborate with well equipped international centers, to further investigate such situations.