Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 12 de 12
Filter
1.
Rev Neurol (Paris) ; 177(6): 670-675, 2021 Jun.
Article in English | MEDLINE | ID: mdl-33066995

ABSTRACT

INTRODUCTION: Cerebral venous thrombosis (CVT) are underdiagnosed in sub-saharan Africa where publications are uncommon. Our study aim was to describe the CVT diagnostic and therapeutic features through a senegalese case series. PATIENTS AND METHOD: A monocentric retrospective and prospective study was conducted at the adult Neurology department of Fann Teaching Hospital in Dakar (Senegal), between January 01, 2013 and April 30, 2020. It had included all CVT cases diagnosed by neurovascular imaging. RESULTS: Seventy CVT cases were collected including 48 women (68.6%). The average age of the patients was 35.2±14 years. The main neurological signs were headache (92.8%) and motor deficit (41.4%), with subacute onset in 67.2% of cases. The superior sagittal sinus (54.3%) and the transverse sinus (38.6%) were the most affected with multiple involvements in 27 patients (38.6%). Thirty patients (42.8%) had indirect parenchymal signs such as venous infarction (15.7%), cerebral edema (11.4%) or intracerebral hemorrhage (12.8%). The etiological factors were mostly infectious (41.4%) with meningoencephalitis (12.8%) and otorhinolaryngological infection (10%). Gyneco-obstetric factors (27%) and Behçet's disease (7%) were the main aseptic factors. In the short-term clinical course, curative anticoagulation (98.6%) had enabled a favourable outcome (mRS 0-1) in half of the patients. CONCLUSION: Our study, the largest series in sub-saharan Africa to this date, confirms that CVT is a young women disease. Infectious etiology is the most frequent at the Fann national teaching hospital (41.4% in Dakar against 6.5% in Germaine Bousser's series) even if the etiological assessment is limited by financial constraints (no coagulopathy/thrombophilia check-up).


Subject(s)
Intracranial Thrombosis , Neurology , Venous Thrombosis , Adult , Africa South of the Sahara , Female , Hospitals, Teaching , Humans , Middle Aged , Pregnancy , Prospective Studies , Retrospective Studies , Senegal , Young Adult
3.
Bull Soc Pathol Exot ; 112(3): 137-146, 2019.
Article in French | MEDLINE | ID: mdl-31825191

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 Adult
4.
Rev Neurol (Paris) ; 172(3): 242-7, 2016 Mar.
Article in English | MEDLINE | ID: mdl-26993564

ABSTRACT

INTRODUCTION: Sleep disorders are diverse in Parkinson's disease. We aimed to assess the quality of sleep in patients with Parkinson's disease in an African population. METHODS: In a transversal and prospective study from April to June 2014, all parkinsonian patients followed at the Fann Teaching Hospital Neurology Clinic (Dakar, Senegal) were assessed using the Hoehn and Yahr's scale and filled out the following questionnaires: Parkinson's disease sleep scale (PDSS), the Pittsburgh Sleep Quality Index (PSQI), and the Epworth Sleepiness Scale (ESS). A PDSS score<82 (or a subscore<5) and a PSQI score>5 indicated poor quality or impaired sleep. An ESS score>10 indicated excessive daytime sleepiness. We used the Pearson coefficient to search for correlation between age, disease stage, disease duration, and the importance of sleep impairment. RESULTS: Hoehn and Yahr staging was 2.42±0.90 in the 35 patients (60% male, mean age 65.7±7.4years, disease duration 32.4±23.4months). The mean total PDSS score was 99.5±24.1 and 74.3% of the patients had an abnormally high PSQI score, indicating high frequency and intensity of sleep disorders. Most frequent disorders were pain or cramps interrupting sleep, night waking to urinate and fatigue or sleepiness on waking. Patients exhibited excessive diurnal sleepiness in 22.9% of the cases; they often had an abnormal PSQI score. Both the total PDSS score and the difficulty to sleep increased with disease stage, but not with age or disease duration. CONCLUSION: We found evidence of major alteration of sleep quality in Senegalese Parkinson patients.


Subject(s)
Parkinson Disease/physiopathology , Sleep Wake Disorders/physiopathology , Age Factors , Aged , Antiparkinson Agents/therapeutic use , Black People , Disease Progression , Female , Hospitals, Teaching , Humans , Male , Middle Aged , Parkinson Disease/complications , Parkinson Disease/epidemiology , Prospective Studies , Senegal/epidemiology , Sleep Wake Disorders/epidemiology , Sleep Wake Disorders/etiology , Surveys and Questionnaires
5.
Rev Neurol (Paris) ; 170(10): 608-13, 2014 Oct.
Article in French | MEDLINE | ID: mdl-24953171

ABSTRACT

INTRODUCTION: Epilepsy is a public health problem in Senegal and Africa because of its severity and its social importance. It occurs at any age sparing no sex. It can influence sexual life and reciprocally. Our aims were to study the effects of antiepileptic drugs on the sexual lives of women with epilepsy, the influence of these drugs on pregnancy and breastfeeding. METHODS: We conducted a prospective study from 1st March to 31st August 2011 in the neurological department of the Fann-Dakar teaching hospital Senegal. Only women with epilepsy were included. RESULTS: We collected 120 patients aged 16-64years with a mean age of 30.58years, 45% married, 44.16% were uneducated preponderant. All patients were taking antiepileptic drugs, 89.16% was alone. Fifty-five percent of our patients had epilepsy for at least 6years; 45.83% had generalized epilepsy; 44.17% of partial seizures. In our cohort, 64.16% were under phenobarbital, 69.16% had good adherence. As side effects of drugs, 90% had sexual problems. Seventy-five percent enjoyed an active sex life. A decrease in the number of sex per week for the disease [31/55=56.66%] was noted. In addition, 51.17% were using contraception, including 38.7% of oral kind and 64.86% had noticed an increase in seizure frequency during their pregnancies. Of the 74 women who had contracted a pregnancy, 41.89% had premature infants, 16.21% have made abortions and 61.17% had psychosocial life affected. DISCUSSION AND CONCLUSION: People with epilepsy often experience sexual problems that may be caused by epilepsy, antiepileptic and/or reactions of the partner and the other facing the diagnosis of epilepsy.


Subject(s)
Anticonvulsants/pharmacology , Anticonvulsants/therapeutic use , Epilepsy/drug therapy , Reproductive Health , Sexuality/drug effects , Adolescent , Adult , Female , Humans , Middle Aged , Prospective Studies , Senegal , Young Adult
6.
Arch Pediatr ; 20(11): 1212-1218, 2013 Nov.
Article in French | MEDLINE | ID: mdl-24090669

ABSTRACT

Congenital hypomagnesemia is a rare disease, with an impact on cognitive and neurological development. We report on three familial cases of congenital hypomagnesemia, two boys and one girl who belong to the same consanguineous family. They all presented neonatal seizures and a psychomotor developmental delay. Cerebral computed tomography showed cerebral atrophy and calcifications in one case and magnetic resonance imaging found predominant cerebellar atrophy in the two other cases. All three patients also had hypocalcemia, hyperphosphoremia, and hypomagnesemia. The parathyroid hormone blood level was low in two cases and normal in the third. One 7-month old patient died. The others received a supplementation of calcium and magnesium, which normalized calcemia, phosphatemia but not magnesemia, which remained low despite high doses. They have both developed cognitive and behavioral impairments.


Subject(s)
Hypocalcemia/diagnosis , Magnesium Deficiency/congenital , Magnesium Deficiency/diagnosis , Renal Tubular Transport, Inborn Errors/diagnosis , Seizures/etiology , Atrophy , Brain/pathology , Calcinosis , Consanguinity , Female , Humans , Hyperphosphatemia/genetics , Hypocalcemia/congenital , Hypocalcemia/genetics , Infant , Infant, Newborn , Magnesium Deficiency/genetics , Male , Parathyroid Hormone/blood , Renal Tubular Transport, Inborn Errors/genetics
8.
Rev Neurol (Paris) ; 168(3): 216-20, 2012 Mar.
Article in French | MEDLINE | ID: mdl-22340866

ABSTRACT

Senegal, like many African countries is facing the so-called demographic and epidemiological transition leading to the development of neurological diseases. These diseases dominated by stroke and status epilepticus are public health priorities with a high prevalence, high lethality and high cost of care. These diseases are managed at the department of neurology, Fann Teaching Hospital, Dakar-Senegal (the only one) with a 65 beds capacity. Unfortunately, access care to the clinic is lately associated with human and material resource scarcity. To improve the management of patients at the clinic, it is important to increase resources (human and material), sensitize the population on early access to health services and prevention of risk factors.


Subject(s)
Emergency Medical Services/organization & administration , Nervous System Diseases/therapy , Brain Injuries/complications , Brain Injuries/therapy , Coma/etiology , Coma/therapy , Demography , Developing Countries , Humans , Paralysis/therapy , Seizures/therapy , Senegal , Stroke/therapy
9.
Med Trop (Mars) ; 71(2): 176-8, 2011 Apr.
Article in French | MEDLINE | ID: mdl-21695878

ABSTRACT

Cryptococcal meningitis is much less common in children than adults. The purpose of this report is to describe 3 cases of cryptococcal meningitis observed in children admitted to the Neurology Department of the Fann University Hospital Center in Dakar, Senegal between July 2003 and November 2008. There were 2 girls whose ages were 8 and 15 years and one 9-year-old boy. All 3 patients presented acute or chronic meningoencephalitis. Diagnosis was based on direct microscopic examination of India ink preparations of cerebrospinal fluid (CSF) showing Cryptococcus neoformans at direct exam. Two patients were immunocompromised including one presenting severe protein-caloric malnutrition and one infected by HIV-1. The third patient was immunocompetent. All 3 patients were treated by intravenous Fluconazole. The immunocompetent boy died after 1 month of hospitalization due to cardiovascular and respiratory insufficiency. Both girls survived with severe neurosensory sequels. Cryptococcal meningitis that is relatively frequent in adulthood may be underestimated in children and should be tested for in any children presenting meningoencephalitis of undetermined cause.


Subject(s)
AIDS-Related Opportunistic Infections/diagnosis , Cryptococcus neoformans/isolation & purification , Immunocompromised Host , Meningitis, Cryptococcal/diagnosis , AIDS-Related Opportunistic Infections/drug therapy , AIDS-Related Opportunistic Infections/virology , Adolescent , Anti-HIV Agents/therapeutic use , Antifungal Agents/therapeutic use , Child , Drug Therapy, Combination , Fatal Outcome , Female , Fluconazole/therapeutic use , Follow-Up Studies , Humans , Male , Malnutrition/complications , Meningitis, Cryptococcal/cerebrospinal fluid , Meningitis, Cryptococcal/drug therapy , Meningitis, Cryptococcal/microbiology , Risk Factors , Treatment Outcome
10.
Bull Soc Pathol Exot ; 103(4): 230-2, 2010 Oct.
Article in French | MEDLINE | ID: mdl-20431984

ABSTRACT

A central nervous system infection due to Morganella morganii is uncommon. We report a case diagnosed at the neurological department of Fann teaching hospital in Dakar, Senegal. A 12-year-old boy was hospitalized for acute meningoencephalitis. The CT scan was normal and the study of cerebrospinal fluid (CSF) revealed cytological and biochemical abnormalities and M. morganii. HIV and syphilitic serologies were negative and blood CD4 lymphocyte count showed 354 per mm(3). The treatment with cefotaxime associated with gentamicin for 6 weeks was successful. The outcome of infection depends on many factors such as the onset and quality of treatment, the virulence of the germ and the status of immune system.


Subject(s)
Cefotaxime/therapeutic use , Enterobacteriaceae Infections/diagnosis , Gentamicins/therapeutic use , Meningoencephalitis/microbiology , Morganella morganii , Anti-Bacterial Agents/therapeutic use , CD4-Positive T-Lymphocytes/immunology , Child , Drug Therapy, Combination , Enterobacteriaceae Infections/drug therapy , Enterobacteriaceae Infections/immunology , Humans , Male , Meningoencephalitis/drug therapy , Meningoencephalitis/immunology , Senegal , Treatment Outcome
11.
Med Trop (Mars) ; 69(3): 306, 2009 Jun.
Article in French | MEDLINE | ID: mdl-19702160

ABSTRACT

Intramuscular injection of benzathine-benzylpenicillin can cause acute transverse myelopathy. The purpose of this report is to describe a case of acute transverse myelopathy observed after injection of benzathine-benzylpenicillin in a 38-year-old man. The patient who was married and had a history of eczema was admitted to the Department of Neurology of the Fann University Teaching Hospital in 2006. All laboratory findings were normal except high serum immunoglobulin E level. An immunoallergic reaction involving inflammatory transverse myelopathy secondary to vasculitis was proposed as the most likely underlying mechanism. Treatment with corticosteroid and physiotherapy led to a favorable outcome. Health personnel should know the indications for use of benzathine-benzylpenicillin and be aware of the possible medullary complications.


Subject(s)
Myelitis/etiology , Penicillin G Benzathine/administration & dosage , Penicillin G Benzathine/adverse effects , Adult , Humans , Injections, Intramuscular/adverse effects , Male , Penicillin G Benzathine/immunology , Senegal , Vasculitis/complications , Vasculitis/immunology
12.
Dakar Med ; 53(2): 105-10, 2008.
Article in French | MEDLINE | ID: mdl-19634543

ABSTRACT

OBJECTIVE: Describe the epidemiology of stroke among patients hospitalized at the Clinic of Neurology , Fann University, Dakar-Senegal. METHODOLOGY: Retrospectively, sociodemographic, medical history and clinical data were collected for patients hospitalized for stroke from January 1st 2001 to November 1st 2003 and to whom a Computed Tomography scan of the brain was done. RESULTS: The population of study (314 patients) had a mean age of 61.3 years (+/-13.8) and was composed of 56.1% of women. The mean time of admission was 8.4 days (+/-23.5). The leading risk factors of stroke were hypertension, history of stroke and diabetes. Ischemic stroke represented 60.2%. The occurrence of stroke was associated with coma and hypertension. The letality rate was 24.8%. CONCLUSION: It is necessary to develop and implement health education program against risk factors for the population to reduce stroke morbidity and mortality.


Subject(s)
Stroke/epidemiology , Aged , Female , Humans , Male , Middle Aged , Outpatient Clinics, Hospital , Retrospective Studies , Risk Factors , Senegal/epidemiology
SELECTION OF CITATIONS
SEARCH DETAIL
...