Awaking a sleeping epidemic

Abstract

Two patients with African sleeping sickness (SS) presented to the neurology unit, Pretoria Academic Hospital, during 2004 and 2005. SS has shown a recent resurgence, with epidemics in the Sudan, Angola and the Democratic Republic of Congo. The number of infected people in Africa is currently estimated at more than 500 000. According to the World Health Organization (WHO), about 20 Trypanosoma brucei gambiense and 30 T. b. rhodesiense infections are diagnosed yearly outside endemic areas in Africa. Migration, tourism, peacekeeping and military interventions and the re-emergence of SS epidemics might increase these numbers.1 The electroencephalogram (EEG) is often useful in the diagnosis of coma and delirium, but has not been widely used in the diagnosis of SS. The EEG is proposed as a novel way to follow disease progression, treatment response and treatmentinduced encephalopathy.