[Dépistage de l'épilepsie en zones tropicales: validation d'un questionnaire en Mauritanie]. / Dépistage de l'épilepsie en zones tropicales: validation d'un questionnaire en Mauritanie.

Prevalence of epilepsy in developing countries is considered to be 2 to 5 times superior to the industrialized countries. In tropical areas, the diagnosis of epilepsy is still reliant on the clinic and requires a precise semiological description. A good epidemiological and clinical research requires standardized and validated screening tools. The objective of this work was to evaluate the validity of the screening module of the investigation questionnaire on epilepsy in tropical areas, in Nouakchott, Mauritania. All the patients included in the study were examined at first by a neurologist, then directed towards an investigator who asked the 5 screening items of the investigation questionnaire. Any person answering "yes" at least one question was regarded as "suspected of epilepsy" by the investigator. Secondly the neurologist re-examined the subjects and confirmed the diagnosis. The sensitivity and the specificity of the module of screening were calculated. On the whole, 236 patients were included in the study 131 had answered "yes" at least one of the questions of the module of screening and was regarded as "suspected" of epilepsy (55.5%) by the questionnaire. The diagnosis of epilepsy was made for 82 subjects by the neurologist. The sensitivity of the module of screening of the epilepsy was 95.1% (CI 95%: 87.3-98.4) and specificity was 65.6% (CI 95%: 57.5-72.9). The screening module of the investigation questionnaire of epilepsy in tropical zones, made up only by 5 questions, has diagnosis qualities acceptable and comparable with those reported in the literature. The use of this tool integrated in a more general questionnaire of investigation of the. epilepsy proves to be an essential instrument in conducting epidemiologic studies in epileptology' in tropical zones.

[Electroencephalograms (EEG) in 250 patients with epilepsy in a cysticercosis endemic area in Burundi]. / Electroencéphalogrammes réalisés chez 250 patients épileptiques dans une zone d'endémie cysticerquienne au Burundi.

OBJECTIVES: This work aimed at describing EEG abnormalities in epileptic patients living in areas endemic for cysticercosis, underlining the electroclinical correlations and discussing the interest of EEG examination in this context. METHODS: During a case-control study, 250 EEGs from patients with epilepsy were recorded with a portable system. Types of seizures were assessed clinically and from information obtained through a standardised questionnaire, and along with EEG were related to the results of cysticercosis serological tests. RESULTS: Among the 249 EEGs, 48% were normal, 5.2% had epileptic abnormalities, 6.8% showed an association between epileptic abnormalities and slow alterations. Slow theta and delta abnormalities were found in 21.8% of cases, and isolated deterioration of basic rhythms was observed in 17.3% of cases. Most seizures were generalized, and 61% of the patients had positive serology. One EEG was uninterpretable and another showed isolated spikes. Electroclinical agreement was considered to be satisfactory in 33 patients, and was better with the epileptic than with slow abnormalities. The existence of epileptiform EEG abnormalities confirmed clinically diagnosed epilepsy, but did not allow etiological diagnosis. Electroserological agreement was good in 24 patients. A significant association (Chi2, p = 0.03) existed between slow focal abnormalities and positive cysticercosis serology. Conversely, no significant association was detected between epileptic patterns and serology results. CONCLUSION: While the EEG alone clearly does not allow aetiological diagnosis, its joint use with clinical and biological results was a key element of the etiological and therapeutic discussion. When it shows focal abnormalities in a patient with epilepsy living in a high prevalence cysticercosis area, it confirms the clinical suspicion of neurocysticercosis. Morphological imagery alone can provide etiological information on the seizures by showing the nature and localization of the parenchymal lesions.

[Comparison of sociocultural attitudes towards epilepsy in Limousin (France), in Togo and in Benin (Africa)]. / Comparaison des représentations socioculturelles des épilepsies en Limousin (France), au Togo et au Bénin (Afrique).

Sociocultural attitudes continue to have a negative impact on management of epilepsy in many African countries and in a few advanced countries. The purpose of this study was to compare attitudes toward epilepsy in France and two African nations: Togo and Benin. A total of 305 epileptic patients over 18 years of age were interviewed using the same quantitative questionnaire about their beliefs, knowledge attitudes and practices regarding their disease. There were 77 patients from the Limousin region in France, 129 from the rural canton of Nadoba in Togo and 99 from the coastal province in Benin. The frequency of epileptic seizure during the last two years prior to the study was lower in France than in Togo and Benin. The number of people who believed in supernatural causes of epilepsy was higher in Togo and Benin whereas the number of people attributing the disease to social causes (e.g. death and stress) was higher in France. Few epileptic patients in France thought that the disease was contagious whereas many patients in both Togo and Benin still believed that the disease was contagious and that some foods were forbidden. More patients in France than in Togo and Benin were aware of the relationship of epilepsy with alcohol, drug abuse and cerebral injury. Epileptic patients in France were more likely to consult a physician and use medical drugs for the treatment of epilepsy than their counterparts in Togo and Benin. Epileptic patients in Togo often complained of social exclusion. Although sometimes contradictory, these findings support the idea that sociocultural attitudes should be taken into account in the management of the disease.

[Early auditory evoked potentials in normal sheep and in sheep with trypanosomiasis]. / Potentiels évoqués auditifs précoces chez le mouton sain et chez le mouton trypanosomé.

In human and animal clinics, the early auditory potential has been used for a long time in the detection of lesions through the internal auditory way in the cerebral trunk. The aim of this work tries to determine if this non invasive test is apt to show up and to follow the evolution of lesions at the level of auditory way in the cerebral trunk of sheep with trypanosomiasis. According to the human technic, the list of the early auditory potential was realized against ten healthy sheep and ten sheep with trypanosomiasis (Trypanosoma brucei brucei) at the nervous phase. No significant anomalies exist in the sheep with trypanosomiasis. The results are discussed.

[Early brain stem auditory evoked potentials in brain death]. / Potentiels evoques auditifs précoces du tronc cérébral dans la mort cérébrale.

Brain-stem auditory evoked potentials (BAEPs) are realized after the first flat EEG in 50 patients. BAEPs were absent in 70% of the patients. In 22% of the patients, one- or two-sided peak I persists. In 8% the peaks I, II and IV exist after the first flat EEG. BAEP evolution with the course of time is realized. A complete disappearance is established after 24 h. The useful advantage of BAEPs in the early diagnosis of brain death is discussed.