[Guillain-Barré syndrome in hospitals in Togo]. / Syndrome de Guillain-Barré en milieu hospitalier au Togo.

Introduction: In sub-Saharan Africa characterized by limited resources especially in health facilities and a relatively higher frequency of infectious diseases, studies on Guillain-Barré syndrome (GBS) are rare. Objectives: The objectives of this work are to describe the characteristics of GBS in Togo through a cohort of patients followed in the neurology unit of the Campus University Hospital of Lomé. Methodology: The study took place from May 2015 to July 2019. Patients with GBS of levels 1 to 3 of the Brighton criteria for diagnostic certainty were included consecutively and assessed at admission, at 6 months and at 1 year with the GBS disability score and the MRC sum score. Qualitative and quantitative variables were expressed, respectively, in frequency and median (interquartile range). Results: Out of 7012 hospitalized patients, 28 (0.39%) including 20 women (71%) with a median age of 40 (27-53) years, presented GBS. The clinical presentation mainly consisted of bilateral sensory-motor disorders predominantly in the lower limbs associated with facial diplegia and preceded by an infectious event. On admission, 39% of patients (n=11) were able to walk (GBS score 0 to 3) and the median MRC sum score was 28 (12-38). Cytoalbuminologic dissociation was present in 654% of patients (13 of 20 patients who underwent lumbar puncture). The demyelinating and axonal subtypes each accounted for 47% (9 of 19 patients who underwent an electroneuromyography examination). Immunoglobulins and intravenous corticosteroid therapy were administered in 18% (n=5) and 50% (n=14) of patients, respectively. Lethality rate during hospitalization was 11% (n=3). The median MRC sum score at 6 and 12 month-outcome were 40 (38-49) and 51 (46-58), respectively. After one year of evolution, case fatality rate was 18% (n=5), and 78% of survivors (n=14) could walk without assistance, of which 17% (n=3) were asymptomatic. Conclusion: In Togo, GBS, with a low hospital prevalence, remains a serious condition due to its high morbidity and lethality related to non-optimal treatment and delayed management.

[Neurological manifestations of Gougerot and Sjögren disease: a Black African case]. / Les manifestations neurologiques du syndrome de Gougerot et Sjögren: à propos d'un cas en Afrique noire.

Primitive Gougerot-Sjögren syndrome (PGSS) is a systemic autoimmune exocrinopathy in which twenty percent of affected patients develop neurological manifestations. It has been little described in the Black African literature. We report a case of PGSS in a 64-year-old Black woman as revealed by neurological manifestations in an inflammatory context. Central neuropathy was present and the patient fulfilled at least four of the six Vitali American-European diagnostic criteria. There were abnormal aspects on the sylvian artery and hyperintense lesions of periventricular predominance. PGSS is a serious disease which we must consider when we encounter any unexplained neurological manifestations especially those associated with vasculitic lesions.

[Vascular age and cardiovascular risk in patients suffering from stroke]. / Âge vasculaire et risque cardiovasculaire chez les patients victimes d'accident vasculaire cérébral.

AIMS: To determine the vascular age of patients suffering from stroke and their cardiovascular risk at 10 years and to compare their vascular age to their real age. MATERIAL AND METHODS: It was about a descriptive and retrospective study carried up from 1st January 2012 to 31st December 2013 at the neurologic clinic of the University teaching hospital Sylvanus Olympio of Lome from patients' files with a confirmed diagnostic of stroke according to the clinical examination and the scanner data. RESULTS: One hundred and ninety-four patients were related to our study. They were shared-out into 101 men and 93 women equal to a sex-ratio (man/woman) of 1.08. The average real age was of 57.6 ± 13.7 years. High blood pressure was the main risk factor with a prevailing rate of 86.6%, followed by the total hypercholesterolemia (54.3%), the hypocholesterolemia HDL (22.7%), diabetes (10.8%) and nicotinism addiction (4.1%). The average vascular age for all patients was of 68.23 years. The average difference between the real age and the vascular age was of 10 years. The average cardiovascular risk at 10 years in our study was of 13.2%. CONCLUSION: The vascular age of patients suffering from stroke at the University teaching hospital Sylvanus Olympio of Lome is 10 years higher than their real age. This condition considerably increases their risk of cardiovascular diseases. The screening and the early care about vascular risk factors appear therefore of utmost importance.

[Disseminated cysticercosis: report of three cases in Togo]. / Cysticercose disséminée: trois cas au Togo.

We report 3 cases of disseminated cysticercosis (DC) in adult male subjects in Togo. All had consulted in dermatology for asymptomatic subcutaneous nodules. The diagnosis was confirmed by histology of a resected nodule. Computed tomography allowed us to bring out the widespread dissemination of cysticerci. The skin, brain, muscle, eye, thyroid, and pleura were the affected organs. Treatment was based on albendazole and betamethasone, with adverse side effects in 2 of our 3 patients. Our 3 observations seem to be the first of their kind in Togo. The mechanism of contamination in these disseminated forms is not yet elucidated, however ingesting a gravid proglottis could be the basis of the widespread dissemination of cysticerci in the body. No consensus has yet been established in the treatment of DC and the management should follow the guideline for treatment of neurocysticercosis and ocular cysticercosis.

[Cerebral infarction after ovarian hyperstimulation in the era of thrombolysis]. / Infarctus cérébraux secondaires à une hyperstimulation ovarienne à l'ère de la thrombolyse.

Ischemic stroke is a very rare complication but classic ovarian hyperstimulation. We report the cases of three young women aged 35, 37 and 27 years. All three were victims of ischemic formed by proximal occlusion of the middle cerebral artery secondary to ovarian hyperstimulation. The first and the third had a proximal occlusion of the right middle cerebral artery occlusion and the second of the left middle cerebral artery. The last two have benefited from a patient intravenous thrombolysis. The first patient did not receive thrombolysis because it was out of time. Against by their evolution was different. The first has almost recovered its deficit, the second sequelae quite heavy after craniectomy and the third died despite her craniectomy.