ABSTRACT
Introduction. Caracterisee par une demyelinisation de la substance blanche du systeme nerveux central; la Sclerose en plaques (SEP) se manifeste cliniquement par des tableaux encephaliques et/ ou medullaires subaigus. Il existerait un gradient Nord-Sud dans la repartition de la maladie. Les populations africaines (noires en particulier) et orientales seraient moins atteintes. La Mauritanie; par la diversite ethnique de sa population et sa situation geographique (trait d'union entre ces 2 regions) peut constituer un terrain interessant pour l'etude de cette maladie. De plus l'introduction de l'IRM dans notre pratique medicale depuis juillet 2005; constitue un atout pour le diagnostic de cette affection.Objectif. Presenter des observations de patients mauritaniens dont les tableaux cliniques et les explorations etaient en faveur d'une SEP. Methode. Nous avons selectionne 4 observations de malades hospitalises dans le Service de Neurologie du Centre Neuropsychiatrique de Nouakchott en Mauritanie; en 2005. Apres un examen clinique neurologique; ils avaient beneficie d'une exploration par IRM. Resultats. Le plus jeune de notre serie a 17 ans et le plus age 55 ans. Tous les patients etaient d'ethnie maure; trois etaient de race noire et un etait de race blanche. Tous ont presente des signes fortement evocateurs de SEP. Nous avons observe une forme d'emblee progressive; deux formes remittentes; et une premiere poussee chez une jeune fille. Les resultats de l'IRM cerebrale chez les 4 patients et de l'IRM medullaire chez trois patients ont montre des plaques de demyelinisation. Un seul patient pu avoir l'electrophorese des proteines du LCR qui a permis de montrer une distribution oligoclonale
Subject(s)
Demyelinating Diseases , Mauritania , Multiple Sclerosis/diagnosisABSTRACT
Background : Locked-in syndrome is an extremely difficult neurologic condition to recognize; especially by the non-specialists. A case of locked-in syndrome in a 41-year old Niger Deltan Nigerian with relapsing remitting form of multiple sclerosis (MS) is presented; including a detailed literature review. Patient and Case Report The patient was in a state of spastic quadriplegia; motionless and aphasic (mute); with the preservation of consciousness and the ability to open and blink the eyes and move them vertically. Two episodes of the disease; varying in duration; have been described. The diagnosis of MS was made from the history and the typical clinical presentation: history of relapsing and remitting signs and clinical evidence of multi-focal involvement of the central nervous system. Conclusion Patient died at the age of 45 years; from pulmonary complications. This article may enhance easy recognition and management of the syndrome by all clinicians
Subject(s)
Multiple Sclerosis/diagnosis , Prognosis , Quadriplegia , ReviewABSTRACT
Background : Locked-in syndrome is an extremely difficult neurologic condition to recognize; especially by the non-specialists. A case of locked-in syndrome in a 41-year old Niger Deltan Nigerian with relapsing remitting form of multiple sclerosis (MS) is presented; including a detailed literature review. Patient and Case Report The patient was in a state of spastic quadriplegia; motionless and aphasic (mute); with the preservation of consciousness and the ability to open and blink the eyes and move them vertically. Two episodes of the disease; varying in duration; have been described. The diagnosis of MS was made from the history and the typical clinical presentation: history of relapsing and remitting signs and clinical evidence of multi-focal involvement of the central nervous system. Conclusion Patient died at the age of 45 years; from pulmonary complications. This article may enhance easy recognition and management of the syndrome by all clinicians