Is Guillain-Barre syndrome following chickenpox a parainfectious disease? A case report and literature review.

BACKGROUND: Polyradiculoneuropathy following infection with varicella zoster virus (VZV) is rare and most of the time, happens in the context of reactivation of latent VZV. We report a case of acute polyradiculoneuropathy following primary infection with VZV marked by atypical clinical features raising the hypothesis of a para-infectious disease. CASE PRESENTATION: We describe a 43-years-old male who developed ataxia, dysphagia, dysphonia, and oculomotor disorders (vertical binocular diplopia and bilateral ptosis) followed by quadriplegia with areflexia which occurred 4 days later. The patient had a history of varicella that occurred 10 days before the onset of these symptoms. Nerve conduction study revealed features consistent with an acute motor-sensory axonal neuropathy (AMSAN). Anti-ganglioside antibodies were negative. Based on clinical presentation and ancillary examination, we retain the Miller Fisher/Guillain-Barré overlap syndrome diagnosis. The patient was treated with high doses of methylprednisolone but the evolution of the disease was nevertheless marked by a complete recovery six weeks after onset of symptoms. CONCLUSION: GBS following varicella is a rare but severe disease occurring most often in adults and marked by greater involvement of the cranial nerves. Its clinical features suggest that it is a para-infectious disease. Antiviral therapy has no effect on the course of the disease but its administration within the first 24 h after the onset of chickenpox in adults can prevent its occurrence.

Post-stroke Complications and Mortality in Burkinabè Hospitals: Relationships with Deglutition Disorders and Nutritional Status.

Stroke frequently causes deglutition disorders, leading to a decline in nutritional status and complications, and increasing mortality. Sub-Saharan data are scarce. The objectives of this study were to assess complications and mortality among hospitalized patients in Burkina Faso during the first two weeks after stroke, and to investigate associated factors. Patients with stroke were followed prospectively in Ouagadougou and Bobo-Dioulasso hospitals. Deglutition disorders and nutritional parameters were assessed at baseline (D0) and on Days 8 (D8) and 14 (D14). Complications and mortality were recorded up to D14. Factors associated with complications and mortality were investigated using multivariate analysis. Of the 222 patients included, 81.5% developed at least one complication, and mortality was 17.1%. At D0, D8, and D14, the rate of deglutition disorders was 37.4%, 28.4%, and 15.8%, respectively, and that of undernourishment 25.2%, 29.4%, and 31.0%, respectively. In multivariate analysis, only the presence of deglutition disorders was a risk factor for developing at least one complication (OR = 5.47, 95% CI 1.81-16.51). Factors predicting death were the presence of deglutition disorders at D0 (OR = 7.19, 95% CI 3.10-16.66), and at least one seizure during follow-up (OR = 3.69, 95% CI 1.63-8.36). After stroke, the rates of complications, death, and undernourishment were high compared to Western countries. Prevention and management of deglutition disorders, and specific follow-up of patients with seizures could reduce post-stroke mortality.

Prevalence of neuropathic pain among Black African patients suffering from common low back pain.

To study the prevalence and semiotic characteristics of neuropathic pain in the common low back pain to the Black African subject. This was a prospective cross-sectional survey carried on from April 1 2009 to August 31 2009 in consultations of rheumatology, neurology, and neurosurgery at the University Hospital Yalgado Ouédraogo in Ouagadougou (Burkina Faso). All patients with a low back pain or a common lomboradiculalgie were included. DN4 questionnaire was used for the diagnosis of neuropathic pain. One hundred and seven patients have been recruited during the study period; Sixty-four (59.80%) were female (sex ratio M/F: 0.67). The average age was 34.11 ± 13.46 years of age with extremes of 20 and 79. The average duration of disease was 48.53 months with extremes of 10 days and 50 years. Eighty-seven patients (81.31%) had a disease duration, which was 3 months longer. Sixty-six patients (61.70%) had a predominant lomboradiculalgie; among the remaining 41, low back pain predominated. Average intensity of pain was 62.81 ± 22.43 (on a scale of 100). A sign of Lasèque was present in the 41 (38.30%) patients. Fifty-three (49.5%) patients had a neuropathic pain. The prevalence of neuropathy signs according to the DN4 questionnaire was as follows: burning (n = 37; 34.58%), painful cold (n = 13; 12.15%), electric shocks (n = 31; 38.97%), pins and needles (n = 34; 31.77%), tingling (n = 35; 32.71%), numbness (n = 45; 42.05%), itching (n = 18; 16.82%), touch hypoesthesia (n = 35; 32.71%), pinprick (n = 33; 30.84%), and tactile allodynia (n = 21; 19.62%). Among the studied variables, the presence of a radiculalgy was statistically associated with neuropathic pain. The lomboradiculalgie of the Black African subject associates neuropathic pain observed in half of patients. Treatment must therefore always take account of this association. However, further studies are needed before any definitive conclusion.

[Risk factors and aetiologies of stroke in young adults in Bogodogo university hospital, Ouagadougou]. / Facteurs de risque et etiologies des avc de l'adulte jeune au chu de Bogodogo a Ouagadougou.

INTRODUCTION: Stroke is a common and serious disease occurring most often in the elderly. The aim if our study was to describe risk factors and causes of stroke in young adults. PATIENTS AND METHODS: This was a retrospective study including patients whose age was between 15 and 45 years, hospitalized in the neurology department of the Bogodogo University Hospital for stroke between April 1, 2017 and March 31, 2019. RESULTS: Forty-four stroke cases involved young adults, it represented 8.46% of total stroke. Among those cases, 59,1% was ischemic stroke and 40,9% was hemorrhagic stroke. The Mean age was37,45± 5,94 years. The sex-ratio was 2,14. Physical inactivity(72,22%), high blood pressure(59,09%) and diabetes(25%) were the main risk factors. Aetiologies were found in 77,27% of cases. They were dominated by atherosclerosis and cardioembolism in ischemic stroke, and by high blood pressure in hemorrhagic stroke. CONCLUSION: Stroke in young adults at Bogodogo University Hospital is relatively infrequent. Prevention of risk factors would prevent an increase in its frequency.

INTRODUCTION: Les accidents vasculaires cérébraux (AVC) sont des pathologies graves survenant le plus souvent chez le sujet âgé. Le but de ce travail était d'étudier les facteurs de risque et les étiologies de l'AVC de l'adulte jeune. PATIENTS ET MÉTHODES: Il s'est agi d'une étude transversale et rétrospective incluant tous les sujets d'âge compris entre 15 et 45 ans, hospitalisés pour AVC dans le service de neurologie du CHU de Bogodogo entre le 1er Avril 2017 et le 31 Mars 2019 et ayant un dossier complet. RÉSULTATS: Quarante-quatre cas d'AVC concernaient les sujets jeunes, soit 8,46% de l'ensemble des AVC. On notait 59,1% d'AVC ischémique et 40,9% d'AVC hémorragique. L'âge moyen était de37,45± 5,94 ans. Le sex-ratio était 2,14. La sédentarité (72,22%), l'HTA (59,09%) et le diabète (25%) étaient les principaux facteurs de risque. L'étiologie a été retrouvée chez 77,27% des patients. Il s'agissait principalement de l'athérosclérose et les cardiopathies emboligènes pour l'AVC ischémique et de l'HTA pour l'AVC hémorragique. CONCLUSION: Les AVC du sujet jeune sont relativement peu fréquents au CHU de Bogodogo. Une prévention des facteurs de risque vasculaire permettrait d'éviter une augmentation de leur fréquence.

[Clinical and paraclinical profile of autoimmune myasthenia gravis in Ouagadougou, Burkina Faso]. / Profil clinique et paraclinique de la myasthénie auto-immune à Ouagadougou au Burkina Faso.

Introduction: Certain differences in the epidemiological, clinical, paraclinical and evolution profiles of autoimmune myasthenia gravis (AIMG) are increasingly described in patients according to geographic origins. The present study was carried out in order to help characterize the socio-demographic, clinical and paraclinical profile of AIMG in Ouagadougou, Burkina Faso. Patients and methods: This was a cross-sectional, descriptive, multicenter, hospital study carried out in Ouagadougou (Burkina Faso), over a period of 5 years 6 months, from March 2015 to September 2019. The study concerned all patients who had a clinical symptomatology suggestive of myasthenia gravis, associated with the presence in the serum of anti-AChR Ab and / or anti-MuSK Ab and / or the presence of a >10% decrement in electroneuromyography and / or a positive therapeutic test for oral anticholinestherasics. Sociodemographic, clinical and paraclinical variables, were analyzed. Results: A total of 25 patients (15 women and 10 men), were included. The young adult form was predominant (20 cases). The median time between the first symptoms and the diagnosis was 28.4 months +/- 44.8 (2 - 217 months). Diplopia and/or ptosis (80%) and dysphonia (72%) were the most frequent revealing clinical presentations. On admission, 7 patients (28%) had a moderate generalized form (MGFA class III) and 9 patients (36%) had a severe to very severe generalized form (MGFA class IV to V). Plasma Ab assays were performed in 17 patients (68%): anti-RACh Ab were positive in 11 patients (64.7%) and anti-MuSK Ab in 3 patients (14.3%). Thoracic CT revealed thymus hyperplasia in 12 patients (48%), thymoma in 5 patients (20%). Hyperthyroidism was associated in 2 patients (8%). Conclusion: AIMG in Ouagadougou, Burkina Faso is marked by delayed diagnosis, a predominance in young women, severe generalized forms and a high frequency of plasma anti-MuSK Ab. This profile appears to be different from that of Caucasian patients. Collaborative studies in the sub-Saharan region on AIMG in general populations are needed.

Frequency of recurrent stroke in Burkina Faso: an observational hospital based study of 6 months.

INTRODUCTION: studies on stroke recurrence are rare in sub-Sahara Africa. The aim to this study is to determine the prevalence and risk factors for recurrent stroke in two University Teaching Hospital in Burkina Faso. METHODS: this prospective cross-sectional study was carried on 266 stroke patients admitted in two hospitals in the city of Ouagadougou from September 1, 2017 to February 28, 2018. Patients with stroke recurrence (ischemic or hemorrhagic) were included. RESULTS: of 266 acute stroke patients included, 44 (16.4%) had recurrent stroke. The mean age of patients was 66.5 ± 11.49 years with male predominance. Hypertension was the most vascular risk factors (81.8%). Previous stroke was ischemic in 61.4%, hemorrhagic in 22.7% and unknown in 15.9% of cases. Poor compliance (< 60%) was determined in patients taking antiagregant (43.6%) and statins (50%). At admission, the most neurological disorders was motor deficit (100%), aphasia (84.1%), and deglutition disorders (15.9%). CT scan showed ischemic in 82% and hemorrhagic stroke in 18% of cases. With the analysis of second stroke, recurrent stroke after intracerebral hemorrhage was hemorrhagic in 77.8% and ischemic in 22.2%. Recurrent stroke after ischemic stroke was ischemic in 100%. CONCLUSION: stroke recurrence is common in our context. Hypertension was the most common vascular risk factor in recurrent stroke. Poor compliance was determined in patients taking antiagregant agents and statins in previous stroke.

Hemorrhagic stroke following snake bite in Burkina Faso (West Africa). A case series.

BACKGROUND: Snake bites remain a major medical problem in West Africa, and hemorrhagic stroke following a snakebite has emerged as a rare secondary condition. The objective of this study was to determine the neurological complications following snake bite. METHODS: This study included all the cases of hemorrhagic stroke following snake bite admitted in the neurology Department of Yalgado Ouedraogo University Teaching Hospital during the period from January 1st, 2018 to December 31st 2019. RESULTS: Three cases of hemorrhagic stroke following snake bite were included in the study. The strokes occurred 4-15 days after the snakebite. Traditional treatment was applied in two cases. Complications were significant, including local manifestations and severe anemia in 2 patients who received blood transfusion. Snake anti-venom was applied. At admission, motor deficit, conscience disorders and fever were the most frequent complaints. Patients received repeated dose of snake anti-venom was applied, antitetanus prophylaxis and antibiotherapy during hospitalization. The majority of the patients had completely recovered. CONCLUSIONS: Hemorrhagic stroke following snake bites are rare in Burkina Faso. Clinical outcome of stroke was favorable after treatment by antivenom, anti-tetanus serum and antibiotics.

Conceptual framework for establishing the African Stroke Organization.

Africa is the world's most genetically diverse, second largest, and second most populous continent, with over one billion people distributed across 54 countries. With a 23% lifetime risk of stroke, Africa has some of the highest rates of stroke worldwide and many occur in the prime of life with huge economic losses and grave implications for the individual, family, and the society in terms of mental capital, productivity, and socioeconomic progress. Tackling the escalating burden of stroke in Africa requires prioritized, multipronged, and inter-sectoral strategies tailored to the unique African epidemiological, cultural, socioeconomic, and lifestyle landscape. The African Stroke Organization (ASO) is a new pan-African coalition that brings together stroke researchers, clinicians, and other health-care professionals with participation of national and regional stroke societies and stroke support organizations. With a vision to reduce the rapidly increasing burden of stroke in Africa, the ASO has a four-pronged focus on (1) research, (2) capacity building, (3) development of stroke services, and (4) collaboration with all stakeholders. This will be delivered through advocacy, awareness, and empowerment initiatives to bring about people-focused changes in policy, clinical practice, and public education. In the spirit of the African philosophy of Ubuntu "I am because we are," the ASO will harness the power of diversity, inclusiveness, togetherness, and team work to build a strong, enduring, and impactful platform for tackling stroke in Africa.

Frequency and Mortality Risk Factors of Acute Ischemic Stroke in Emergency Department in Burkina Faso.

OBJECTIVE: To determine the prevalence of ischemic stroke deaths and their predictive factors in the Emergency Department at Yalgado Ouedraogo University Teaching Hospital (YOUTH). Methodology. This was a retrospective study with an analytical and descriptive focus over a period of three years from January 1, 2015, to December 31, 2017. RESULTS: During the study period, 302 acute ischemic stroke patients with a mean age of 62.2 ± 14.26 years were included. Atrial hypertension was the most common vascular risk factor in 52.5%. On admission, 34.8% of patients had loss of consciousness. The mean time to perform brain CT was 1.5 days. The average length of stay was 4 days. Electrocardiogram, echocardiography, and cervical Doppler were not performed during hospitalization in ED. The mortality rate was 39%, respectively, 37.6% in male and 41.6% in female. The mean age of patients who died in ED was 63.6 ± 13.52 years. Hypertension was the most common vascular risk factors in 54.2% of death. After logistic regression, the predictors of death were past history of heart disease, consciousness disorders, hyperthermia, hyperglycemia on admission, poststroke pneumonia, and urinary tract infection. CONCLUSIONS: Acute ischemic stroke was frequent in Emergency Department with high mortality rate. The mortality risk factors were the same than those found in literature. This higher mortality can be avoided by early diagnosis and an adequate management.

Spontaneous Subarachnoid Haemorrhage in Neurological Setting in Burkina Faso: Clinical Profile, Causes, and Mortality Risk Factors.

To determine the prevalence, clinical profile, causes, and mortality risk factors of spontaneous arachnoid haemorrhage at Yalgado Ouedraogo University teaching Hospital, we conducted a 5-year retrospective study of 1803 stroke patients admitted to Neurology Department during the period from January 2012 to December 2016. During the study period, spontaneous subarachnoid haemorrhage accounted for 3.2 % of all stroke. The mean age of patients was 60 years (range 20-93 years). There was a female predominance in 55.9%. The common vascular risk factors were hypertension (79.7%) and chronic alcohol consumption (16.9%). The main symptoms were headache (76.2%), motor weakness (74.5%), and consciousness disorders (62.7%). Neurological examination revealed limb weakness in 76.2% and meningeal irritation in 47.4%. The best admission Glasgow Coma Scale score of 15 was found only in 37.3 % of patients. About 50.8% of patients were admitted to Hunt and Hess moderate grade (III) resulting in a mortality of 24.80%. The main cause of spontaneous subarachnoid haemorrhage was hypertension (77.9%). Cause could not be determined in 8.5 % of cases. The mortality rate was 37.3%. There was high mortality in patients with intraventricular haemorrhage and in patients with disturbances of consciousness. In conclusion, our study showed a poor frequency of spontaneous subarachnoid haemorrhage with high mortality. Hypertension was the most common cause of spontaneous subarachnoid haemorrhage.

[Anxiety and depression during chronic renal failure before end stage at the University hospital center Yalgado Ouedraogo of Ouagadougou (Burkina Faso)]. / Anxiété et dépression au cours de l'insuffisance rénale chronique avant le stade terminal au centre hospitalier universitaire Yalgado Ouédraogo de Ouagadougou (Burkina Faso).

AIM: We wanted to know the prevalence of depression and anxiety, as well as the associated factors in patients with chronic renal failure in Burkina Faso. PATIENTS AND METHODS: This was an analytical cross-sectional study conducted from February to May 2016. We included all adult patients with moderate or severe chronic renal failure. The diagnosis of anxiety and depression was made using the Hamilton scales. Identification of factors associated with both conditions required bi- and multivariate analyzes. RESULTS: The study involved 191 patients, with a mean age of 53.2±14.2 years and a sex ratio of 1.4. The prevalence of anxiety and depression was 42.4% and 66.5%, respectively. In 37.7% of cases, both anxiety and depression were noted. The mean age was 52.2±13.1 years for anxious patients and 53.5±13.3 years for the depressed. After multivariate analysis, female sex (odds ratio 2.2; adjusted P=0.014) was significantly associated with anxiety, and anxiety itself at depression (odds ratio 7.5; adjusted P<0.001). CONCLUSION: Anxiety and depression are very common during moderate or severe chronic renal failure in Burkina Faso. In view of their potentially serious consequences, there is a definite interest in their early detection by the nephrologist, especially in the female patient, and for early management.

Etiologies of non-genetic epilepsies of child and adolescent, newly diagnosed in Ouagadougou, Burkina Faso.

INTRODUCTION: in sub-Saharan Africa, epilepsy is common and mainly concerns children before the age of 15 years. The data on childhood epilepsy is parcel, but a high prevalence of non-genetic epilepsy is frequently reported. EEG, TDM and MRI devices are rare. The aim of this work was to study the etiological aspects of non - genetic epilepsy of the child and adolescent, newly diagnosed in Ouagadougou, Burkina Faso. METHODS: This was a cross-sectional, descriptive, multicentric study, from 01/01/2016 to 31/12/2016, involving patients aged 0 to 18 years old, epileptic, newly diagnosed, in the city of Ouagadougou. Each patient included in the study was to have had an EEG and brain CT scan and/or brain MRI and to gather the anamnestic and electro clinical arguments for non-genetic epilepsy. Sociodemographic, clinical, EEG and neuroradiological data were analyzed. An univariate analysis was used to determine the electro-clinical and neuro-radiological characteristics associated with epilepsies of structural causes. RESULTS: In all 115 patients were collected, with an average age of onset of epilepsy of 8.2 years, a male predominance with a sex ratio to 1.67. Risk factors of epilepsy was present in 74.8%; They were dominated by perinatal events in 79.1%. Focal seizures, daily frequency of these seizures and focal epilepsy, were predominant, respectively in 53%, 58% and 60.9% of cases. Brain scan and Brain MRI where performed in 90.4% and 9.6% of patients, respectively. The brain sequelaes of perinatal adverse events, the sequelae of central nervous system infections, and the sequelae of cranial and brain trauma, with 34.8%, 14.8%, and 5.2% respectively, were the main causes of non- genetic epilepsies of the child and adolescent. No cause was identified in 37.4% of cases. CONCLUSION: The improvement of policies in the field of maternal and child health and the generalization of the control of infectious and parasitic diseases, including malaria, may contribute to the reduction of non-genetic epilepsy in sub-Saharan Africa.

The Prevalence of migraine and associated factors among medical students in Ouagadougou (Burkina Faso) / A prevalência da enxaqueca e fatores associados entre estudantes de medicina em Ouagadougou (Burkina Faso)

Objective: To determine the prevalence, clinical characteristics and impact of migraine among medical students in the city of Ouagadougou. Methods: This across-sectional study was carried out during a period of 6 months from August 2021 to January 2022. Participants were selected by stratified random sampling according to academic level. Hetero-administered questionnaire was administred to each student. Migraine was diagnosed according to the ICHD 3rd edition criteria and the MIDAS was used to assess the impact of migraine on students' quality of life. Results: Two hundred and twenty seven students were selected for this study. The prevalence of migraineurs was 31.8%. Their mean age was 22.20±2.67 years. There was female predominance among the migraineurs (73.9%). More than half of the migraineurs had a family history of headache disorders (53.6%). Migraine without aura was the most frequent subtype (59.4%). Visual aura was predominant (78.2%). Migraine was of moderate intensity in 60.8% of cases. Insomnia and/or lack of sleep was the most common trigger (73.7%) followed by stress and fatigue in 71% of cases. Migraine caused severe disability in 15.9% of migraineurs. Conclusion: There was a high prevalence of migraine among medical students in Burkina Faso. Stress and irregular sleep were the most common triggers factors.

Objetivo: Determinar a prevalência, características clínicas e impacto da enxaqueca entre estudantes de medicina na cidade de Ouagadougou. Métodos: Este estudo transversal foi realizado durante um período de 6 meses, de agosto de 2021 a janeiro de 2022. Os participantes foram selecionados por amostragem aleatória estratificada de acordo com o nível acadêmico. Questionário heteroadministrado foi aplicado a cada aluno. A enxaqueca foi diagnosticada de acordo com os critérios da 3ª edição da ICHD e o MIDAS foi utilizado para avaliar o impacto da enxaqueca na qualidade de vida dos estudantes. Resultados: Duzentos e vinte e sete alunos foram selecionados para este estudo. A prevalência de enxaquecas foi de 31,8%. A média de idade foi de 22,20±2,67 anos. Houve predomínio do sexo feminino entre os portadores de enxaqueca (73,9%). Mais da metade dos pacientes com enxaqueca tinha histórico familiar de cefaleia (53,6%). A enxaqueca sem aura foi o subtipo mais frequente (59,4%). A aura visual foi predominante (78,2%). A enxaqueca foi de intensidade moderada em 60,8% dos casos. A insônia e/ou falta de sono foi o gatilho mais comum (73,7%), seguida de estresse e fadiga em 71% dos casos. A enxaqueca causou incapacidade grave em 15,9% dos pacientes com enxaqueca. Conclusão: Houve uma alta prevalência de enxaqueca entre estudantes de medicina em Burkina Faso. Estresse e sono irregular foram os fatores desencadeantes mais comuns.

Therapeutic route of patients at the acute phase of their stroke in Burkina Faso.

INTRODUCTION: The advent of the neurovascular units and thrombolysis has improved support for stroke in developed countries. Our objective was to study the therapeutic route of stroke patients in Burkina Faso, a country with limited resources. METHODS: It was a prospective cohort study over a period of 4months, from February 02, 2014 to June 05, 2014, in medical emergencies and Neurology department of the teaching hospital Yalgado Ouedraogo. The study focused on patients diagnosed with stroke through brain imaging when they first entered hospital or during hospitalization. Variables of the study included socio-demographic data of the patients, route of the patients, nature of the stroke, treatment and clinical course. RESULTS: The time between the onset of clinical signs and the first contact with a peripheral public health unit extended from 30min to 24h with an average of 6h and 56min. The minimum time between the first contact with a peripheral public health unit and medical emergencies of the Teaching Hospital Yalgado Ouédraogo was 15min, and the maximum, two weeks. After their arrival in medical emergencies, patients spent on average 21h and 18min to achieve the cerebral CT scan. Concerning the treatment, the thrombolysis, which was not available yet, had never been prescribed, while 19% of patients were eligible according to the 4h30mn period criteria. CONCLUSION: Our study shows that the long delay in the access of neurological expertise is, in most cases, related to the therapeutic route of patients. Thus, the setting-up of a stroke sector would improve the management and the prognosis of cases in Burkina Faso.

Post-stroke epilepsy in Burkina Faso (West Africa).

Post-stroke epilepsy (PSE) is defined as "recurrent seizures following stroke with confirmed diagnosis of epilepsy". Our objective was to describe the epidemiological, clinical and therapeutic PSE aspects at the Yalgado Ouedraogo Teaching Hospital, the main reference centre for neurological conditions in Burkina Faso. We conducted a retrospective study from January 2006 to December 2014. The data on thirty-two (32) cases of PSE was collected from a total of 1616 patients hospitalized for stroke, representing a rate of 1.98%. The patients' ages ranged from 25 to 77years old with a mean age of 58±10.39. There were 21 men and 11 women, with a gender ratio of 1.9. The time of occurrence of PSE ranged between 10 and 3600days (10years). The brain CT scan helped distinguish the different subtypes of stroke. Sixty-four percent (64%) of the cases experienced ischemic stroke and 36% of the cases cerebral hemorrhage. With regard to medical treatment, 23 patients received monotherapy, and 4 patients dual therapy. Exactly 96.87% of seizures were stabilized during the hospitalization period. PSE is a symptomatic type of epilepsy occurring during stroke sequelae. It is important not to lose sight of this before the occurrence of any focal or generalized seizure after a stroke.

[Factors associated with depressive symptoms in chronic hemodialysis patients of centre hospitalier universitaire Yalgado Ouédraogo (Burkina Faso)]. / Facteurs associés à la symptomatologie dépressive chez les patients hémodialysés chroniques du centre hospitalier universitaire Yalgado Ouédraogo (Burkina Faso).

OBJECTIVE: To determine the factors associated with depressive symptoms in chronic hemodialysis patients at centre hospitalier universitaire Yalgado Ouédraogo de Ouagadougou (CHU-YO). PATIENTS AND METHODS: The study was cross sectional and descriptive, from June 2nd to July 30th, 2014. We included chronic hemodialysis patients of CHU-YO. The frequency of hemodialysis sessions was of every four to five days. The French version of Hamilton depression psychometric scale was used to assess depressive symptoms. The factors associated with depression were identified after descriptive and explanatory analysis. RESULTS: Depressive symptoms were identified in 140 of the 162 patients included in the study, or a prevalence of 86.4%. The average age of the 140 patients was 38.9±12.9years. In bivariate analysis, the risk of having depressive symptoms was 1.5 times for women, 1.7 times for patients with severe anemia, 1.5 times for hemodialysis catheter holders, 1.8 both in case of duration in hemodialysis less than six months. In multivariate analysis, gender and duration in hemodialysis were factors associated with the occurrence of depressive symptomatology. CONCLUSION: Our study confirms the high frequency of depressive symptoms in patients on hemodialysis. To improve the overall care of hemodialysis patients, we suggest routine screening for depressive symptoms and specific support.

Knowledge and practice concerning swallowing disorders in hemiplegic patients among nurses of Bobo-Dioulasso urban primary health care centers in Burkina Faso.

INTRODUCTION: The quality of management of swallowing disorders (SD) from admission onwards influences the patients' nutritional status and their prognosis. Neurological diseases are the main causes of SD, affecting one in three patients with hemiplegia (Hp). In Burkina Faso (BF), primary health care center (PHCC) nurses are the first to manage these patients, but there are no data related to their management of SD. The study aimed to assess knowledge and practices regarding SD in Hp among PHCC nurses in Bobo-Dioulasso, a main center for care of Hp in BF. METHODS: This cross-sectional study was performed August 1-September 15 2014. Subjects underwent a standardized survey to determine their knowledge and practices concerning SD in Hp. RESULTS: Of 125 nurses surveyed (83.3% of the targeted workers), 82.4% had experience of caring for Hp. The role of the central nervous system in cases of Hp and SD was recognized by 56.8% of nurses; 42.3% knew that SD can cause aspiration, and 36.0% were aware of rescue techniques to use when aspiration occurs; 39.2% correctly assessed the impact on nutritional status of SD. Knowledge in this area was better among respondents who recently completed training school. 65.6% and 1.6% respectively knew about the impact of posture and the texture of food on the ability to swallow. Among the 103 nurses with experience of treating Hp, 68.0% considered clinical interview the best way to detect SD, and 30.1% did not give the patient advice in this area. In multivariate analysis, detection of SD was associated with good knowledge of the value of voice disorders (OR = 3.5, 95% CI = 1.4-8.1; p = 0.005). CONCLUSION: Few nurses had been warned of the connection between Hp and SD, which are classic issues and potential complications. Practices varied, but most were not in accord with what are recognized as good strategies for SD screening and management. In order to improve care of Hp, neurological and nutritional training should be accompanied by specific training in SD, emphasizing screening and simple management.

[Tuberculosis and stroke: case report and literature review]. / Tuberculose et accident vasculaire cérébral: un cas et revue de la littérature.

UNLABELLED: Tuberculosis remains a public health problem in Côte-d'Ivoire, a sub-saharan region country, where infection with a prevalence of 2-10% increase tuberculosis incidence assesed to 290 per 100,000 habitants. Authors report a case of a ischemic stroke (IS) and unknown HIV and tuberculosis infection; discuss these infections responsibility in the occurrence of this IS and past neurological signs. The patient presented with a left hemiparesis without infectious sign nor drowsiness. Medical history noticed a weight loss and two months ago a completely regressive tetraparesia. CT cerebral scan didn't found other sign than a IS located in the right middle cerebral artery territory as describe in the literature. The cerebrospinal fluid (CS) blood cell count was high and Mycobacterium tuberculosis (MT) was found at direct exam. Positive HIV blood serology and MT where noticed at direct spit smears without chest radiograph lesion. After MT six month treatment progresses was good with no MT in CS and spit smears. Because of financial problems HIV treatment was unitialized at this time and MT was prolonged to 12 months. Literature point out different forms sometimes associated of intracranial tuberculosis (meningitis, hydrocephalus, tuberculoma, milliary, abscess, empyema). MT at direct exam was scarce, in spite of news biological methods MT diagnosis can be difficult and need a biopsy or a test treatment. Arachnoid's enhancement is frequent but MT can be misdiagnosed by CT scan which is sometimes less efficient than IRM. CONCLUSION: This case argue that tuberculosis may be evocated as a stroke aetiology especially in presence of HIV infection even if some cardiovascular risk factors are present.