Nodding syndrome is an epileptic encephalopathy associated with neuroinflammation and tauopathy. This initially pediatric brain disease, which has some clinical overlap with Methyl-CpG-binding protein 2 (MECP2) Duplication Syndrome, has impacted certain impoverished East African communities coincident with local civil conflict and internal displacement, conditions that forced dependence on contaminated food and water. A potential role in Nodding syndrome for certain biotoxins (freshwater cyanotoxins plus/minus mycotoxins) with neuroinflammatory, excitotoxic, tauopathic, and MECP2-dysregulating properties, is considered here for the first time.
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Response to letter from Catamo, Costa, Buque & Nzwalo (2024) titled "Possible role of mycotoxins, malnutrition and MECP2 dysregulation in nodding syndrome" regarding Spencer, Valdes Angues & Palmer's paper titled "Nodding syndrome: A role for environmental biotoxins that dysregulate MECP2 expression?" JNS. 2024;462:123077. Doi: 10.1016/j.jns.2024.123077.
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Department of Neurology, School of Medicine, Oregon Health & Science University, Portland, OR, USA; Third World Medical Research Foundation, Portland, OR, USA. Electronic address:
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