[Familial congenital hypomagnesemia revealed by neonatal convulsions]. / Convulsions néonatales révélant une hypomagnésémie congénitale familiale.

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.

[The therapeutic itinerapy of epileptics admitted by the Electoencephalographic Laboratory at CHU Dakar]. / Itineraire thérapeutique des malades recus dans le laboratoire d'eeg du CHU de Fann.

In Senegal, as in other under developed countries, the delays before seeking medical treatment are long varying from 2 to 12 according to studies. This is related to the fact that in traditional African communities, prejudices and believes delayed medical management which is seeked after failure of traditionnal treatments. The objectives of this study concerning therapeutic itinerary of epileptics in the EEG laboratory at the Neurology Department at CHU in Dakar were to evaluate the average latency of medical consultation and to identify the recourse path by patients receiving antiepileptic treatment. We conducted from March to may 2001, a cross disciplinary study, with a sample size of 212 patients. 79.2% of patients were less than 30 years old. They first seek treatment in hospitals in 36.8%, traditional practionners in 35.8%, health centers in 23%, and private clinics in 4%. The average delay of treatment in modern structures was by 13.4 +/- 4.7 months. The towards the healers was linked to faulty beliefs in 61.8% of the cases, lack of information (22.4%), or a lack of financial means (2.6%). The patients were refeared to traditional healers in 6.7% of the cases for reasons of confidence in traditional medecine. The orientation to neurology clinic was recommended by health personal in 83% of the cases, family (14.6%), or the healer (1.4%). The long and difficult journey of epileptics in Senegal remains marked by exclusion, absence or delay of medical attention.

[Vascular parkinsonian syndrome in 21 case studies, two of which were anatomic]. / Syndromes parkinsoniens vasculaires à propos de 21 observations dont 2 cas anatomiques.

A clinicopathological study of parkinsonian syndrome witch occurred after stroke, is done by the authors. That is a retrospective study concerning 2 anatomic cases from 21 vascular parkinsonism. All the patients were admitted in the clinique neurologique de Fann from 1970 to 1990. They were 15 men and 6 women. Their age ranged between 45 to 75 years (mean 59.66). The 2 autopsied cases had lesions located in the thalamus as the superior part and a discreet cortical atrophy in the one case, and in the other case, we can see similar lesions in the right external capsule and in the inferior part of the putamen. Another lesion of haemorrhage infarct was located in the left temporal lobe. The locus niger was macroscopically normal in the 2 cases. Anatomical lesions observed have been localized in the putamen and in the external capsule in the associatical cerebral cortex in the second case and in the first one, lesions are located in the thalamus and in the cortex. These lesions were not well correlated with neurological signs. The different clinical aspects are discussed. From this study, it results that arterial damages associated with hypertension and atheromatosis might touch dopaminergic structures responsible of parkinsonism with sometime good sensitivity to levodopa.