ALZHEIMER'S DISEASE, AN ASSOCIATION OR A COMPLICATION OF PAGET'S DISEASE? STUDY OF AN OBSERVATION IN GUINEA.

If Paget's disease can undermine Alzheimer's disease, there is the possibility of an association between Alzheimer's disease and Paget's disease. We report the observation of an 81-year-old hypertensive patient with Alzheimer's disease, who presented with an isolated increase in alkaline phosphatase, which led to the discovery of Paget's disease. The physician must therefore be careful to distinguish between genuine Alzheimer's disease and a neurological complication of Paget's disease.

CLINICAL AND IMAGING ASPECTS OF TALAR OSTEOCHONDRITIS: A CASE REPORT FROM GUINEA.

Osteochondral lesions of the dome of the talus are becoming an increasingly frequent problem in sports traumatology, and questioning is a major element in the diagnostic orientation, as these are usually young, athletic patients. The main part of the diagnosis is based on complementary imaging examinations. We report the clinical observation of an adult patient, an athlete, referred to a rheumatology consultation for chronic pain of the right ankle with a mechanical appearance and difficulty in walking. Clinical and paraclinical examinations (standard X-ray, CT scan and magnetic resonance imaging) finally led to the conclusion of an osteochondritis of the talus.

Tablet-based electroencephalography diagnostics for patients with epilepsy in the West African Republic of Guinea.

BACKGROUND AND PURPOSE: Epilepsy is most common in lower-income settings where access to electroencephalography (EEG) is generally poor. A low-cost tablet-based EEG device may be valuable, but the quality and reproducibility of the EEG output are not established. METHODS: Tablet-based EEG was deployed in a heterogeneous epilepsy cohort in the Republic of Guinea (2018-2019), consisting of a tablet wirelessly connected to a 14-electrode cap. Participants underwent EEG twice (EEG1 and EEG2), separated by a variable time interval. Recordings were scored remotely by experts in clinical neurophysiology as to data quality and clinical utility. RESULTS: There were 149 participants (41% female; median age 17.9 years; 66.6% ≤21 years of age; mean seizures per month 5.7 ± SD 15.5). The mean duration of EEG1 was 53 ± 12.3 min and that of EEG2 was 29.6 ± 12.8 min. The mean quality scores of EEG1 and EEG2 were 6.4 [range, 1 (low) to 10 (high); both medians 7.0]. A total of 44 (29.5%) participants had epileptiform discharges (EDs) at EEG1 and 25 (16.8%) had EDs at EEG2. EDs were focal/multifocal (rather than generalized) in 70.1% of EEG1 and 72.5% of EEG2 interpretations. A total of 39 (26.2%) were recommended for neuroimaging after EEG1 and 22 (14.8%) after EEG2. Of participants without EDs at EEG1 (n = 53, 55.8%), seven (13.2%) had EDs at EEG2. Of participants with detectable EDs on EEG1 (n = 23, 24.2%), 12 (52.1%) did not have EDs at EEG2. CONCLUSIONS: Tablet-based EEG had a reproducible quality level on repeat testing and was useful for the detection of EDs. The incremental yield of a second EEG in this setting was ~13%. The need for neuroimaging access was evident.