ABSTRACT
Neuro-Behçet (NB) African studies are mainly North African, but Sub-Saharan Africa is not to be outdone. Our aim was to describe diagnostic and therapeutic features of NB in a Senegalese series collected in Dakar. This was a descriptive and retrospective study conducted at the Neurology department of Fann Teaching Hospital in Dakar, Senegal. All patients who met the NB's diagnostic criteria were included. Sixteen patients were collected, 14 males and 2 females with an average age of 40 years [18-71]. The main neurological signs were motor deficit (13 cases), headache (10 cases), and language disorders (4 cases). Extra-neurological signs were dermatological (14 cases), ocular (2 cases), and articular (2 cases) with aseptic unilateral gonarthritis. Fever was present in 9 patients. Neurological involvement was mostly isolated parenchymal (8 cases) or mixed (6 cases). The main clinical forms of NB were rhombencephalitis (8 cases) and retrobulbar optic neuritis (4 cases). Seven patients had a cerebral angio-Behçet with cerebral venous thrombosis (3 cases), ischemic stroke (2 cases), and intracerebral hematoma (2 cases). Under prednisone (16 cases) and azathioprine (3 cases), the short-term clinical outcome was mostly favorable (14 cases) with a modified Rankin scale at 2. NB is an under-diagnosed adult male disease in Sub-Saharan Africa and further studies are needed.
Les études africaines sur le neuro-Behçet (NB) sont majoritairement maghrébines, mais l'Afrique noire n'est pas en reste. L'objectif de l'étude était de décrire les particularités diagnostiques et thérapeutiques du NB dans une série sénégalaise colligée à Dakar. Il s'agit d'une étude rétrospective à visée descriptive menée à la clinique de neurologie du centre hospitalier universitaire de Fann de Dakar, au Sénégal. Tous les patients répondant aux critères diagnostiques de NB ont été inclus. Seize patients ont été colligés, 14 hommes et deux femmes avec un âge moyen de 40 ans [1871]. Les principaux signes neurologiques étaient un déficit moteur (13 cas), des céphalées (10 cas) et un trouble du langage (4 cas). Les signes extraneurologiques étaient dermatologiques (14 cas), oculaires (2 cas) et articulaires (2 cas) à type de gonarthrite unilatérale aseptique. Une fièvre était présente chez neuf patients. L'atteinte neurologique était majoritairement parenchymateuse isolée (8 cas) ou mixte (6 cas). Les principales formes cliniques de NB étaient la rhombencéphalite (8 cas) et la névrite optique rétrobulbaire (4 cas). Sept patients avaient un angio-Behçet cérébral à type de thromboses veineuses cérébrales (3 cas), d'infarctus cérébraux (2 cas) et d'hématomes intracérébraux (2 cas). Sous prednisone (16 cas) et azathioprine (3 cas), l'évolution clinique à court terme était majoritairement favorable (14 cas) avec un score de Rankin modifié de 2 au moment de l'exeat. Le NB est une maladie de l'homme adulte sous-diagnostiquée en Afrique noire. Des études ultérieures multicentriques nationales et sous-régionales sont souhaitables.
Subject(s)
Behcet Syndrome/complications , Behcet Syndrome/diagnosis , Behcet Syndrome/therapy , Intracranial Thrombosis/diagnosis , Intracranial Thrombosis/etiology , Intracranial Thrombosis/therapy , Adolescent , Adult , Africa South of the Sahara/epidemiology , Aged , Behcet Syndrome/epidemiology , Cerebral Hemorrhage/diagnosis , Cerebral Hemorrhage/epidemiology , Cerebral Hemorrhage/etiology , Cerebral Hemorrhage/therapy , Cohort Studies , Female , Hospitals, Teaching , Humans , Intracranial Thrombosis/epidemiology , Male , Middle Aged , Retrospective Studies , Senegal/epidemiology , Young AdultABSTRACT
to assess : the frequency of emergencies among patients admitted to dermatology departments in Dakar, their most common causes, mortality rate, and the most frequent dermatoses. This one-year prospective study took place in the two reference departments for the treatment of dermatological diseases in Dakar. We have included all patients with a dermatological emergency, regardless of age and gender, as determined by the doctor receiving the patient. The data were entered in Excel and analyzed with R software, version 3.1.2. the study included 189 patients, 40 % of all dermatology department admissions. The sex ratio was 0.89 (M/F) and the average age 49 years. The mean time from arrival to treatment was 30 minutes. Absolute emergencies accounted for 45.4 % of these emergencies, and relative emergencies 54.6 %. Absolute emergencies were dominated by severe drug eruptions (17 %) and relative emergencies by infectious dermatoses (38 %). Emergency measures were carried out in all cases, associated with etiological treatment. The mortality rate was 7 % (n=14), and 5 (36 %) of these deaths were due to severe drug eruptions. Infectious dermatoses and severe drug eruptions are the most frequent emergencies. The high mortality rate, related mostly to drug eruptions, indicates the need for early management and an adequate technical platform.
