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1.
Med Trop (Mars) ; 69(3): 306, 2009 Jun.
Artigo em Francês | MEDLINE | ID: mdl-19702160

RESUMO

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.


Assuntos
Mielite/etiologia , Penicilina G Benzatina/administração & dosagem , Penicilina G Benzatina/efeitos adversos , Adulto , Humanos , Injeções Intramusculares/efeitos adversos , Masculino , Penicilina G Benzatina/imunologia , Senegal , Vasculite/complicações , Vasculite/imunologia
2.
Rev Neurol (Paris) ; 164(2): 162-8, 2008 Feb.
Artigo em Francês | MEDLINE | ID: mdl-18358875

RESUMO

Epilepsy is a significant health public problem in Senegal with an estimated prevalence of 8 to 14%. The aim of this study was to determine the clinical and electroencephalographic features of epilepsy in a cohort of Senegalese infants, search for etiological factors and determine the impact of disease on school life. This retrospective study concerned 459 children who attended the neurological outpatients clinic at the Fann hospital, Dakar, Senegal, between July 2003 and December 2006. All were aged under 19 years. Among the 135 children with idiopathic epilepsy, 23.7% had parental consanguinity and 37.77 % familial epilepsy. Rolandic epilepsy and epilepsy with absences were more frequent but several infants with idiopathic epilepsy were not classified. Non-idiopathic epilepsy was noted in 312 children. In this group, estimates of parental consanguinity and familial epilepsy were of 21.79 and 17.94%, respectively. Etiological factors were predominantly pregnancy and birth abnormalities (28.84%) and central nervous system infection (20.19%). Twelve children had febrile seizures. Of patients with idiopathic epilepsy, 65.18% were attending school versus only 9.29 with non-idiopathic epilepsy.


Assuntos
Epilepsia/epidemiologia , Adolescente , Criança , Pré-Escolar , Estudos de Coortes , Consanguinidade , Epilepsias Parciais/epidemiologia , Epilepsia/classificação , Epilepsia/genética , Epilepsia Tipo Ausência/epidemiologia , Feminino , Humanos , Masculino , Estudos Retrospectivos , Convulsões/etiologia , Senegal/epidemiologia
3.
Rev Neurol (Paris) ; 164(5): 452-8, 2008 May.
Artigo em Francês | MEDLINE | ID: mdl-18555877

RESUMO

BACKGROUND: In Dakar, stroke is the most frequent neurological disease with the highest mortality. Victims may present in a critical state of coma. The objective of this study was to evaluate survival among comatose stroke patients in Dakar, Senegal. METHODS: This was a longitudinal prospective study from April 2006 to July 2007 conducted in the Neurological Intensive Care Unit (NICU) of Fann University Teaching Hospital in Senegal. Were included in the study, all stroke patients confirmed by CT scan with a Glasgow coma score less than or equal to 8/15. Patients with subarachnoid hemorrhage were excluded. RESULTS: A total of 105 patients were evaluated with 54 cases of ischemic stroke among them. The mean age was 61.87+/-14.16 years. The mean duration of hospital stay in the NICU was 10.82+/-11 days with an estimated mortality of 82.9%; the three-month survival was 9.52%. The median overall survival was 7+/-1 days (CI(95%): 5-9). CONCLUSION: Comatose stroke patients have a poor prognosis, emphasizing the crucial importance of primary prevention.


Assuntos
Coma/mortalidade , Acidente Vascular Cerebral/mortalidade , Idoso , Isquemia Encefálica/complicações , Isquemia Encefálica/mortalidade , Hemorragia Cerebral/complicações , Hemorragia Cerebral/mortalidade , Coma/etiologia , Coma/terapia , Feminino , Escala de Coma de Glasgow , Departamentos Hospitalares/estatística & dados numéricos , Humanos , Unidades de Terapia Intensiva , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Prospectivos , Senegal/epidemiologia , Fatores Socioeconômicos , Acidente Vascular Cerebral/etiologia , Acidente Vascular Cerebral/terapia , Sobrevida , Análise de Sobrevida , Tomografia Computadorizada por Raios X
4.
Bull Soc Pathol Exot ; 101(4): 311-3, 2008 Oct.
Artigo em Francês | MEDLINE | ID: mdl-18956812

RESUMO

Cryptococcal infection is common in immunocompromised patients. Its occurrence in immuno-competent patients is rare. We report here 3 cases of neuromeningeal cryptococcosis in patients without any immunosuppressive documented factors. They were respectively 25, 36 and 50 years old presenting clinical signs of chronic meningo-encephalitis. The HIV test was negative for all of them and the CD4 counts were normal. One patient died on the seventh day of the treatment with amphotericin B; the second was discharged on parents' request, while the third patient improved with intravenous fluconazole. This study suggests that when facing a sub-acute or chronic meningitis, an investigation for cryptococcal infection is recommended as before AIDS epidemic.


Assuntos
Meningite Criptocócica/diagnóstico , Adulto , Anfotericina B/uso terapêutico , Antifúngicos/uso terapêutico , Contagem de Linfócito CD4 , Evolução Fatal , Feminino , Fluconazol/uso terapêutico , Soronegatividade para HIV , Humanos , Hospedeiro Imunocomprometido , Masculino , Meningite Criptocócica/imunologia , Pessoa de Meia-Idade , Senegal , Resultado do Tratamento
5.
Med Trop (Mars) ; 68(6): 606-10, 2008 Dec.
Artigo em Francês | MEDLINE | ID: mdl-19639829

RESUMO

Thirty-five percent of stroke events observed in Dakar, Senegal involve hemorrhaging. Coma is a frequent revealing sign of the disease and a severe prognostic factor. Since specific therapy is unavailable in sub-Saharan Africa, only symptomatic medical treatment is proposed to most patients presenting intracerebral hemorrhage. The purpose of this longitudinal study was to evaluate prognosis and survival in patients presenting with intracerebral hemorrhage in a neurological critical care unit in Senegal. Study was conducted from April 15, 2006 to July 18, 2007 in the neurological critical unit of the Fann University Hospital Center in Dakar. Mortality and probability of survival were estimated using Kaplan Meier methods. The predictive value of factors significantly correlated with prognosis was determined by multivariate analysis using a Cox proportional hazards model. A total of 51 cases of intracerebral hemorrhage were included in this study. Mean patient age was 64 years and the sex ratio was 1.13. Median survival was 7 days and mortality in the neurological critical care unit was 80.4%. The probability of survival at days 10, 30 and 90 were 43.14%, 21.57% and 13.73% respectively. Occurrence of a complication on day 3 was shown to be an independent risk factor for early death. Intracerebral hemorrhage with coma is associated with a high mortality rate. Better primary prevention is necessary.


Assuntos
Hemorragia Cerebral/mortalidade , Coma/mortalidade , Adulto , Idoso , Idoso de 80 Anos ou mais , Cuidados Críticos , Feminino , Mortalidade Hospitalar , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Prospectivos , Senegal/epidemiologia , Análise de Sobrevida
6.
Dakar Med ; 53(1): 7-19, 2008.
Artigo em Francês | MEDLINE | ID: mdl-19102112

RESUMO

Strokes (AVC) represent the 1st cause of death in the department of neurology of Dakar. The main characteristic of stroke is the brutality of the method of formation of neurological deficit. The vascular territory in question amends the clinical expression. Besides the motor deficit stroke can cause neuropsychological disorders affecting language, memory, activity gesture, recognition of oneself and its environment, space and extra corporeal body with the result intellectual deterioration. The mechanisms of stroke are dominated by atherosclerosis and embolic heart disease for ischemic stroke and hypertension and ruptures of vascular malformations for hemorrhagic stroke. CT scan remains the key consideration in determining the nature ischemic or hemorrhagic stroke. Because of its acuteness and rapid progress to irreversible injury stroke is a dramatically high priority medical emergency. The therapeutic strategy should follow a pattern efficient and fast leading to a specific care, gradual and coordinated by the 3rd hour. There is a need to recognize stroke, what is the nature (ischemic, hemorrhagic) and the cause, in order to consider a therapeutic care consistent. The care must start at the very beginning of the stroke and continued during transportation. In the acute phase of stroke, lower blood pressure should be gradual and it is recommended to respect an HTA in the order of 180/105 mm HG except under certain conditions (acute lung oedema, aortic dissection, infarction acute myocardial) that requires a rapid stabilization of blood pressure. Thrombolysis using alteplase (rt-PA) is called in neurovasalar units in case of stroke seen before the 3rd hour and in the absence of contraindications. Anticoagulants are shown in prevention of recurrence of stroke in the embolic heart disease with high risk of recidivism, in the carotid stenosis or vertebral basilar tight with hemodynamic impact downstream and in the extensive thrombosis. The treatment antiplatelet medication is indicated in other cases. The screening and the control of risk factors for vascular constitute an effective weapon for primary prevention. The rehabilitation motor, speech and language and occupational therapy can improve rehabilitation for patients. The prognosis vital and functional depend partly in the early and appropriate management of stroke and also in increasing of education and awareness of population and health care personnel and especially on the diffusion of the means of prevention primary


Assuntos
Acidente Vascular Cerebral , Fatores Etários , Anti-Hipertensivos/uso terapêutico , Encéfalo/diagnóstico por imagem , Ensaios Clínicos como Assunto , Diabetes Mellitus Tipo 2/complicações , Diagnóstico Diferencial , Eletroencefalografia , Feminino , Fibrinolíticos/uso terapêutico , Humanos , Hipertensão/complicações , Hipertensão/tratamento farmacológico , Hipolipemiantes/uso terapêutico , Ataque Isquêmico Transitório/diagnóstico , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Inibidores da Agregação Plaquetária/uso terapêutico , Prevenção Primária , Fatores de Risco , Prevenção Secundária , Senegal , Fatores Sexuais , Acidente Vascular Cerebral/diagnóstico , Acidente Vascular Cerebral/diagnóstico por imagem , Acidente Vascular Cerebral/tratamento farmacológico , Acidente Vascular Cerebral/etiologia , Acidente Vascular Cerebral/prevenção & controle , Acidente Vascular Cerebral/terapia , Tomografia Computadorizada por Raios X
7.
Dakar Med ; 53(1): 68-75, 2008.
Artigo em Francês | MEDLINE | ID: mdl-19102120

RESUMO

INTRODUCTION: Aphasias constitute an acquired disorder of the language. Aetiologies are dominated by stroke. The aim of this study was to describe the clinical, epidemiological and evolutionary aspects of the vascular aphasias. MATERIALS AND METHODS: We conducted from August 2003 to May 2005 a descriptive cross-sectional study at the Neurology department in Dakar. This study concerned all patients admitted at the Neurology department for stroke confirmed by the cerebral tom densitometry. All patients were subjected to an examination of the language allowing to confirm the diagnosis of aphasia and to determine the type. The follow-up was monthly during one year. RESULTS: 55 cases of aphasia were reported on 170 cases of stroke (frequency: 32.35%). Our patients were all right-handed. Mean age was 56.8 (28 to 86 years) with a sex-ratio of 0.61.76.36% of the patients could neither read nor to write. Only two made higher studies. The nature of stroke was ischemic in 73.7% and hemorrhagic in 26.3%. The aphasias with expressive language impairment were observed in 96.4% against 3.6% of the cases for aphasias with comprehensive language impairment. After one year of evolution, a regression of the disorders was observed only in 9 cases, and the regression was partial in 25 cases. The evolution of the aphasia was correlated with that of the motor deficit. Age, low educational level, ischemic stroke constitute factors of bad prognosis. CONCLUSION: Vascular aphasias are frequent and of reserved prognosis. It disturbs social professional and family reintegration.


Assuntos
Afasia/etiologia , Acidente Vascular Cerebral/complicações , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Afasia/diagnóstico , Afasia/epidemiologia , Afasia de Broca/epidemiologia , Afasia de Wernicke/epidemiologia , Estudos Transversais , Educação , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Senegal/epidemiologia , Fatores Sexuais , Fatores de Tempo
8.
Dakar Med ; 53(2): 105-10, 2008.
Artigo em Francês | MEDLINE | ID: mdl-19634543

RESUMO

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.


Assuntos
Acidente Vascular Cerebral/epidemiologia , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Ambulatório Hospitalar , Estudos Retrospectivos , Fatores de Risco , Senegal/epidemiologia
9.
Rev Neurol (Paris) ; 163(8-9): 823-7, 2007 Sep.
Artigo em Francês | MEDLINE | ID: mdl-17878809

RESUMO

OBJECTIVES: Because of its acuteness and rapid progress to irreversible injury, stroke is a dramatically high priority medical emergency. The purpose of this prospective study was to ascertain the average time limit for primary management of stroke victims referred to the Senegalese national medical center considered as the final link within the country's healthcare organisation. PATIENTS AND METHODS: We reviewed the files of 170 patients aged 25-90 (average 61+/-13 years). The sex ratio was 0.68. Seventy percent of the patients resided in the nation's capital, Dakar. RESULTS: Most of the patients were referred to a medical center late. Admission was before the 6th hour for only one patient and none of the patients were admitted before the 3rd hour. Late treatment was related to the remoteness of medical centers. Among patients residing in Dakar, the first visit occurred between 6 and 24 hours for 30p.cent versus 7.8 p.cent for patients residing in rural areas of the country. Educational level and socio-economic status had no effect on late treatment. None of the patients were given prehospital care. Treatment was essentially symptomatic in patients with hemorrhagic stroke. Anticoagulants or anti-platelet agents were prescribed for patients with ischemic stroke. Only 29.4 p.cent of patients were given rehabilitation care. Mortality was 50.6 p.cent and the rate of dependency 41.7 p.cent. CONCLUSION: In Senegal, stroke victims receive care too late. This situation arises because of insufficiency of human and material resources and inaccessibility to care centers.


Assuntos
Transtornos Cerebrovasculares/terapia , Adulto , Idoso , Idoso de 80 Anos ou mais , Encéfalo/diagnóstico por imagem , Transtornos Cerebrovasculares/diagnóstico , Transtornos Cerebrovasculares/epidemiologia , Serviços Médicos de Emergência , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Fatores de Risco , Senegal/epidemiologia , Fatores Socioeconômicos , Acidente Vascular Cerebral/terapia , Tomografia Computadorizada por Raios X , Transporte de Pacientes
10.
Ann Readapt Med Phys ; 49(3): 100-4, 2006 Apr.
Artigo em Francês | MEDLINE | ID: mdl-16387385

RESUMO

OBJECTIVE: To evaluate the functional outcome in patients followed in the department of neurology of Dakar for stroke. MATERIALS AND METHOD: Prospective longitudinal observational study from August 2003 to May 2005 included inpatients or outpatients with stroke one month or less from entry confirmed by computed tomography scan. Patients were followed monthly for 12 months. At each visit, data on functional autonomy measured by the Barthel index and the treatments received were collected. RESULTS: One hundred and seventy patients aged 25 to 90 years (mean 61+/-13 years) were evaluated. The sex ratio was 0.68. A total of 64.7% of strokes involved ischemic cerebral vascular accidents and 35.3% hemorrhagic vascular accidents. Right hemiplegia was present in 55.9%, left hemiplegia in 42.9% and bilateral paresis in 1.2% of patients. A total of 28.8% of patients died between d0 and d30, 50.6% within one year. At entry, the Barthel score was greater than 60 in only 4.7% of patients. After one-year follow-up, 58.3% of the patients had a Barthel score greater than 60, 19.1% had a score between 20 and 40 and 22.6% a score between 40 and 60. Only 53.5% received rehabilitation care. The parameters significantly associated with a functional recovery were age less than 55 years (P<0.05), hemorrhagic vascular accident as opposed to ischemic vascular accident (P<0.05), and earlier rehabilitation care under qualified personnel (P<0.01). DISCUSSION: Our study shows an important rate of mortality during the first year following stroke and the rather young age of our population. The parameters associated with a better functional recovery are comparable to most of the data in the literature. The results of our study suggest that it is possible to improve functional prognosis after stroke by setting measures of prevention of the risk factors and rehabilitation in the early management of hemiplegia.


Assuntos
Atividades Cotidianas , Reabilitação do Acidente Vascular Cerebral , Acidente Vascular Cerebral/mortalidade , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Hemiplegia/etiologia , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Pacientes Ambulatoriais , Prognóstico , Senegal , Índice de Gravidade de Doença , Análise de Sobrevida
11.
Dakar Med ; 51(1): 17-21, 2006.
Artigo em Francês | MEDLINE | ID: mdl-16924844

RESUMO

INTRODUCTION: The general objective of this study was to determine the morbid-mortality of stroke followed in the Department of neurology of Dakar. MATERIALS AND METHODS: This prospective and longitudinal studywas carried out from August 2003 at May 2005 and concerned 170 patients hospitalized or seen in external consultation for cerebral vascular accident confirmed by the cerebral tomodensitometry. All the patients were subjected to a protocol allowing determining the sociodemographic data, the therapeutic itinerary, the nature and the mechanism of stroke. The follow-up was monthly for 12 months. RESULTS: The patients were old 25 to 90 years. The mean age was 61 +/- 13 years. The sex-ratio is 0.68. The ischemic cerebral vascular accidents represented 64.7% against 35.3% for the hemorrhagic vascular accidents. In 71.7 the AVCH was related to arterial hypertension. For the AVCI, a cardiopathy emboligene was objectified in 16.36% of the cases. The HTA constituted the principal factor of risk and was observed in 63.53% of the cases. The mortality rate was 28.8% (between j0 and j30) and 50.6% at one year. The age constitutes a factor of bad prognosis. For the sex the statistical analysis shows a no significant difference (p = 0.703). The repetition of stroke constitutes a factor of bad prognosis. 52.4% of the patients having an antecedent of stroke had died precociously. Mortality was higher in the AVCH with p = 0.043. The existence of disorders of conscience of start constituted a factor of bad vital prognosis. Among the 84 survivors after one year of follow-up, 49 had found their functional autonomy and 35 kept after-effects. CONCLUSION: Stroke is responsible for a strong mortality. The advanced age, the repetition of cerebral vascular accident, the hemorrhagic nature of the cerebral vascular accident constitutes factors of bad vital prognosis.


Assuntos
Acidente Vascular Cerebral/mortalidade , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Prospectivos , Senegal/epidemiologia
12.
Seizure ; 14(2): 106-11, 2005 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-15694563

RESUMO

A door-to-door survey was used to determine the prevalence of epilepsy among 4500 people within the Pikine Health District (population 480,000) Senegal. Prevalence was 14.2/1000, and 23.4% of all people with epilepsy had never received appropriate treatment. Figures for the prevalence had increased since a previous survey in 1989. In parallel a study of knowledge attitude and practice was performed in the same district. Salient findings were that: two-thirds of interviewees had at some time witnessed a seizure, 51% agreed when asked if epilepsy is caused by evil spirits, 35% said epilepsy is contagious, only about 18% said that traditional therapy is best, 60% would not mind their child to play with a child with epilepsy but only 32% would agree if their child would want to marry a person with epilepsy.


Assuntos
Epilepsia/tratamento farmacológico , Epilepsia/etnologia , Conhecimentos, Atitudes e Prática em Saúde , Adolescente , Adulto , Área Programática de Saúde , Criança , Pré-Escolar , Epilepsia/epidemiologia , Feminino , Humanos , Lactente , Masculino , Prevalência , Senegal/epidemiologia , População Suburbana , Superstições , Inquéritos e Questionários
13.
Med Trop (Mars) ; 65(5): 458-64, 2005 Nov.
Artigo em Francês | MEDLINE | ID: mdl-16465816

RESUMO

The purpose of this one-year cross-sectional study conducted in 1997 was to estimate the direct cost of stroke management in the Neurology Department of Fann University Hospital in Dakar, Senegal. Data were collected about the type of care services required and related spending. Cost analysis was made in CFA Francs (CFAF), the Senegalese currency (1 USD = 500 CFAF in 1997). A total of 1260 patients were hospitalized in the department including 383 for stroke (30.4%). Mean age was 60.8 +/- 14.2 years and men accounted for 49.2% of the population. The mortality rate was 46.2% among hospitalized patients. A total of 33,573 medical acts were carried out including 12,052 (35.9%) for stroke management. The direct cost of stroke management was 32,614,442 CFAF with a mean cost of 78,426 CFAF per patient. The cost was 18,839 CFAF in the patient care unit (57.8%) and 4,954,635 CFAF in the neuroradiology unit (15.2%). The cost of health care personnel was 19,373,172 CFAF (59.4%) and the cost for drugs and other medical products was 8,253,246 CFAF. Health education programs aimed at increasing awareness of risk factors are needed to reduce the cost of stroke management in this difficult economic period.


Assuntos
Custos de Cuidados de Saúde/estatística & dados numéricos , Acidente Vascular Cerebral/economia , Acidente Vascular Cerebral/terapia , Idoso , Custos e Análise de Custo , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Senegal
14.
Dakar Med ; 50(3): 108-12, 2005.
Artigo em Francês | MEDLINE | ID: mdl-17632991

RESUMO

INTRODUCTION: Common diabetic mellitus complication, neuropathies present various clinical forms. OBJECTIVE to evaluate the hospital frequency and clinical features of diabetic neuropathies. PATIENTS AND METHOD: It is a retrospective study concerning peripheral neuropathies observed in "clinique neurologique" of Dakar between January 1991 and December 2001 in diabetic patients treated for a long time. Inclusion criterion are distal and/or proximal sensitive and/or motor neuropathies with abolition or reduction of patellar reflex. Are excluded neuropathies of others aetiologies. Electrophysiological examination with motor conduction velocity measure is performed in about half of them . One neuro-muscular biopsy was performed using current neuropathological examination including teased fiber technic. RESULTS: 17 cases of peripheral neuropathy are observed on 10,000 documents (0.17%). They were 11 males and 6 females, aged from 27 to 77 years (means 56.41). Among them, 10 cases of distal motor sensitive neuropathy are identified; 2 cases of sensitive neuropathy, 3 cases of pure motor neuropathy and 2 cases of multiple mononeuritis neuropathy with dysautonomic disorders of sphincter and genital type in one of them. Glucose serum level was between 1.25 to 4.25 g/l . Diabetes was 18 months to 20 years of duration at the moment of admission . Normal serum level glucose was rapidly obtained with insulin treatment. The evolution was favourable in 82.9% of cases under anti-diabetic treatment, vitamin B and kinesitherapy. CONCLUSION: diabetes mellitus neuropathies are rare in "Clinique n eurologique" of Dakar where diverse clinical forms are observed. Favourable outcome in most of cases occurred when serum glucose equilibration is rapidly obtained.


Assuntos
Neuropatias Diabéticas/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Senegal
15.
Rev Neurol (Paris) ; 159(3): 316-8, 2003 Mar.
Artigo em Francês | MEDLINE | ID: mdl-12703049

RESUMO

We report a case of crossed aphasia with jargonagraphia in a forty-eight year old right handed monolingual man without family history of handedness or prior neurological illness. He developed a right temporo-insulo-parietal hamatomae documented by CT scan and accompanied by aphasia, left hemineglect, left hemiplegia, left lateral homonymous hemianopsia. The oral language was reduced and writing language was characterised by jargon. The writing and oral comprehension were preserved. This aphasia suggested a relationship between cerebral lateralization of language function and manual preference and the similarity between childhood aphasia and crossed aphasia in right-handed patients.


Assuntos
Afasia/complicações , Transtornos Psicomotores/etiologia , Semântica , Afasia/etiologia , Afasia/fisiopatologia , Encefalopatias/complicações , Encefalopatias/diagnóstico por imagem , Córtex Cerebral/diagnóstico por imagem , Lateralidade Funcional/fisiologia , Hamartoma/complicações , Hamartoma/diagnóstico por imagem , Hemianopsia/etiologia , Humanos , Idioma , Masculino , Pessoa de Meia-Idade , Lobo Parietal/diagnóstico por imagem , Transtornos Psicomotores/diagnóstico , Transtornos Psicomotores/fisiopatologia , Lobo Temporal/diagnóstico por imagem , Tomografia Computadorizada por Raios X
16.
Dakar Med ; 44(1): 49-53, 1999.
Artigo em Francês | MEDLINE | ID: mdl-10797987

RESUMO

Spinal tuberculosis is the first etiology of spinal cord compression in our areas. We are studying the epidemiological, clinical and therapeutic aspects of Pott's disease. We have collected all children aged from 0 to 15 years admitted for Pott's disease in department of Neurology in CHU Fann SenegaIL from January 1st 1983 to December 31st 1997 spinal tuberculosis. The diagnosis was both clinical and paraclinical. 27 children aged to 2-15 years were hospitalized for Pott's disease. The sex-ratio was equal to 2 in favour of boys. 77.77% of patients were consulted more than a month after the outbreak of the paraplegia. The notion of tuberculous contagion was found in 25.92% of the cases. The main clinical signs were paralysis of the limbs, sensory symptoms and bladder sphincter dysfunction. In 96.29% anomaly of disc and vertebra were recorded, more often affecting two vertebrae. The myelography, performed in 13 patients objectivized an epidural stop in 92.30% of the cases. There was a favorable evolution in 92% of patients under antituberculous chemotherapy. Spinal tuberculosis is an affection cheating all ages and it remains the first etiology of spinal cord compression in our areas. Therefore there is a necessity of primary safety by fighting against tuberculosis what is still in our areas.


Assuntos
Compressão da Medula Espinal/microbiologia , Tuberculose da Coluna Vertebral/diagnóstico , Adolescente , Antituberculosos/uso terapêutico , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Senegal/epidemiologia , Tuberculose da Coluna Vertebral/tratamento farmacológico , Tuberculose da Coluna Vertebral/epidemiologia
17.
Dakar Med ; 45(2): 151-3, 2000.
Artigo em Francês | MEDLINE | ID: mdl-15779173

RESUMO

A retrospective study of Friedreich's ataxia was conducted from january 1960 to december 1997. Eighten cases had been collected. Friedreich's ataxia was the second disorder after Pierre Marie's ataxia among inherited ataxia. Parental consanguinity has been found in 27.77% of cases. The sex-ratio was 2.6 for males. 66,67% of Friedreich's ataxia cases began after 25 years. Clinical signs were: cerebellar ataxia, sensitive disorders in 70%, pyramidal syndrom and cardiomyopathy in 22.22%, bones dysmorphy in 50% of cases. Electromyography indicated severe axonopathy of members with decreased somesthesic potentials in six cases. Glycaemia was normal in all cases. Clinical future presented wide variation between one and fourth years old.


Assuntos
Ataxia de Friedreich/epidemiologia , Adolescente , Adulto , Idade de Início , Criança , Pré-Escolar , Consanguinidade , Eletrocardiografia , Eletromiografia , Potenciais Somatossensoriais Evocados , Feminino , Ataxia de Friedreich/diagnóstico , Ataxia de Friedreich/etiologia , Hospitalização/estatística & dados numéricos , Humanos , Incidência , Lactente , Masculino , Pessoa de Meia-Idade , Linhagem , Polimorfismo Genético/genética , Estudos Retrospectivos , Fatores de Risco , Senegal/epidemiologia , Distribuição por Sexo , Saúde da População Urbana/estatística & dados numéricos
18.
Dakar Med ; 45(2): 162-6, 2000.
Artigo em Francês | MEDLINE | ID: mdl-15779176

RESUMO

Through a cohort of 93 neuroaids which has been diagnosed at Dakar in our Neurology Department, the authors evaluated the hospital prevalence of retrovirus, detected socio-demographic factors, related AIDS outline the mean neurological picture and try to correlate survival and neurological involvement of these patients. Among 1151 patients who got retroviral blood test, 93 were seropositive (8.1%). On these repartitions 36 were females (38.7%) and 57 males (61.3%). The age goes from 19 to 76 years old. 45 patients (48.4%) have been found positive for HIV-1 blood test, 21 patients (22.6%) for HIV-2 blood test, 11 patients (11.8%) for both HIV2, 11 patients (11.8%) for HTLV1, 3 patients (3.2%) for both HIV-1 and HTLV1, and 2 patients (2.2%) for both HIV-2 and HTLV1. In our study the transmission of AIDS occur mainly through heterosexual inter course and multiple parternship is a high risk group. The central nervous system deseases represented 68.8% of cases. The pathology were dominated by stroke, myelopathies, meningoencephalotis and spinal cord compression. The peripheral nervous system desease were found in 7.5% of cases. The peripheral facial paralysis occupied the first place in HIV infections of peripheral nervous system deseases (57.1% of cases). When neurological involvement set up the letality is higher for HIV-1 (57% of global letality) and for central system nervous involvement (76.2%).


Assuntos
Infecções por HIV , HIV-1 , HIV-2 , Infecções por HTLV-I , Doenças do Sistema Nervoso , Adulto , Distribuição por Idade , Idoso , Comorbidade , Feminino , Infecções por HIV/complicações , Infecções por HIV/epidemiologia , Infecções por HIV/transmissão , Infecções por HTLV-I/complicações , Infecções por HTLV-I/epidemiologia , Infecções por HTLV-I/transmissão , Hospitalização/estatística & dados numéricos , Humanos , Masculino , Estado Civil/estatística & dados numéricos , Pessoa de Meia-Idade , Doenças do Sistema Nervoso/epidemiologia , Doenças do Sistema Nervoso/virologia , Vigilância da População , Prevalência , Prognóstico , Estudos Retrospectivos , Fatores de Risco , Senegal/epidemiologia , Distribuição por Sexo , Comportamento Sexual , Fatores Socioeconômicos , Inquéritos e Questionários , Saúde da População Urbana/estatística & dados numéricos
19.
Dakar Med ; 45(2): 167-72, 2000.
Artigo em Francês | MEDLINE | ID: mdl-15779177

RESUMO

Because of the apparition of new risk factors and numerous progresses in investigation methods, authors take stock of neurological diseases of patients admitted in Clinique Neurologique of Fann during the last ten years. The 8539 cases repartition is as followed: 4736 males and 3803 female. Their ages ranged between 3 and 80 years with 2130 deaths corresponding to 24.94%. Annual mean of admission is 853 +/- 42 cases. Aetiological data are: stroke (3910 cases 45.78% with 60.56% of death). The following is peripheral neuropathieswith 714 cases(8.61%) and the spinal cord compression with 692 cases (8.10%). Comparision of frequencies of different aetiologies with those of previous studies shows that the small capacity of the neurological department is a restricting factor for the entry frequencies of neurological patients; the principal pathologies got small variations from one decade to another. In the opposite, some aetiologies have disappeared (neurological syphilitis, trypanosomiasis, neurocyticercosis, cerebral mycosis). Some eatiologies remain unprecised (infectious diseases, peripheral neuropathies, degenerative diseases).


Assuntos
Hospitalização/tendências , Doenças do Sistema Nervoso/epidemiologia , Doenças do Sistema Nervoso/etiologia , Saúde da População Urbana/tendências , Adolescente , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Causas de Morte , Criança , Pré-Escolar , Doenças Endêmicas/estatística & dados numéricos , Feminino , Mortalidade Hospitalar , Humanos , Masculino , Pessoa de Meia-Idade , Morbidade , Doenças do Sistema Nervoso/classificação , Doenças do Sistema Nervoso/diagnóstico , Vigilância da População , Estudos Retrospectivos , Fatores de Risco , Senegal/epidemiologia , Distribuição por Sexo
20.
Dakar Med ; 45(1): 81-4, 2000.
Artigo em Francês | MEDLINE | ID: mdl-14666798

RESUMO

A retrospective survey has been conducted from january 1979 to january 1999 about the young inpatients file records of the department of neurology of Dakar. 19 cases of Guillain-Barré's syndrome have been collected, representing 2.3% of the children admitted in the department of neurology. The children were 18 months to 16 years old. The sex ratio was 1.4. Infectious disease has been reported in 68.4% of the cases during the 4 weeks preceding the neurological features. The notion of vaccination was found in 5.3% of the cases. The motor deficit was frequent, represented by paraparesis in 63.2% and quadriparesis in 36.8% of the cases. The mean duration of the hospitalisation was 28 days. 52.6% of the patients have completely recovered from their motor deficit and this recovery was unachieved in 36.8%. No fatal event has been detected. The therapeutical means were represented by vitaminotherapy B1B6B12 associated with kinesitherapy. Our results reveal a less severe evolution and better prognosis of Guillain-Barré's syndrome affecting children, instead of the absence of more appropriate means of treatment such as plasma exchange and intravenous immune globulin.


Assuntos
Síndrome de Guillain-Barré/epidemiologia , Adolescente , Distribuição por Idade , Criança , Pré-Escolar , Progressão da Doença , Feminino , Síndrome de Guillain-Barré/diagnóstico , Síndrome de Guillain-Barré/etiologia , Síndrome de Guillain-Barré/terapia , Hospitais Universitários , Humanos , Incidência , Lactente , Tempo de Internação/estatística & dados numéricos , Masculino , Modalidades de Fisioterapia , Vigilância da População , Prognóstico , Estudos Retrospectivos , Fatores de Risco , Senegal/epidemiologia , Distribuição por Sexo , Tiamina/uso terapêutico , Vitamina B 12/uso terapêutico , Vitamina B 6/uso terapêutico
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