The symptoms are similar to those of a mild traumatic brain injury, but the cause is unknown, with most patients never having experienced head trauma. Physicians in Cuba have identified 522 people who have shown symptoms consistent with this illness since 2016, according to reports from Cuban media and researchers who presented data at (AAN) meeting this weekend.

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The mysterious symptoms include sensory and motor problems, headaches, cognitive issues, sleep disturbances, and visual problems. Some patients also reported hearing loss or impaired balance. “Many patients had objective deficits on exam that correlated with what they were feeling subjectively,” said Dr Raquel Luque, a neurologist at the Instituto de Neurología y Neurocirugía (INN), Havana. Cuban researchers think that “most cases of the disease are not due to a deliberate attack.”

“It is very mysterious and has really captured people’s imagination,” said Dr Andrew D Powers, an assistant professor of neurology at the University of Colorado school of medicine, who was not involved with the research.

The cause is unknown but the symptoms are consistent with an acquired brain injury that impairs cellular metabolism. “It’s more likely due to some sort of direct energy exposure,” said Dr Powers. The same pattern has been seen in patients exposed to other forms of radiation and to certain chemicals, such as solvents and pesticides.

A separate paper presented at the AAN conference identified 11 patients who had “sensorineural hearing loss, dizziness and ear pain”, consistent with reports from some US diplomats in Cuba. Although Cuban researchers think that most of the cases are not deliberate attacks, they note that what has happened to the US diplomats, who were targeted with an unknown mechanism, might be different.

“Based on the pattern of findings, we think there must be something else going on besides just a traumatic injury,” Dr Luque said.

However, reports from the US embassy in Havana suggest that some individuals experienced immediate injuries consistent with “health attacks,” and in some cases these symptoms have persisted.

The US has not identified any device capable of producing the injuries seen in Cuba, and it is unclear whether such a device would produce the pattern of injuries that patients experienced.

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