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Introduction Cerebral venous thrombosis (CVT) are underdiagnosed in sub-saharan Africa where publications are uncommon. Our study aim was to describe the CVT diagnostic and therapeutic features through a senegalese case series. Patients and method A monocentric retrospective and prospective study was conducted at the adult Neurology department of Fann Teaching Hospital in Dakar (Senegal), between January 01, 2013 and April 30, 2020. It had included all CVT cases diagnosed by neurovascular imaging. Results Seventy CVT cases were collected including 48 women (68.6%). The average age of the patients was 35.2 ± 14 years. The main neurological signs were headache (92.8%) and motor deficit (41.4%), with subacute onset in 67.2% of cases. The superior sagittal sinus (54.3%) and the transverse sinus (38.6%) were the most affected with multiple involvements in 27 patients (38.6%). Thirty patients (42.8%) had indirect parenchymal signs such as venous infarction (15.7%), cerebral edema (11.4%) or intracerebral hemorrhage (12.8%). The etiological factors were mostly infectious (41.4%) with meningoencephalitis (12.8%) and otorhinolaryngological infection (10%). Gyneco-obstetric factors (27%) and Behcet's disease (7%) were the main aseptic factors. In the short-term clinical course, curative anticoagulation (98.6%) had enabled a favourable outcome (mRS 0-1) in half of the patients. Conclusion Our study, the largest series in sub-saharan Africa to this date, confirms that CVT is a young women disease. Infectious etiology is the most frequent at the Fann national teaching hospital (41.4% in Dakar against 6.5% in Germaine Bousser's series) even if the etiological assessment is limited by financial constraints (no coagulopathy/thrombophilia check-up).

Neuro-Behcet (NB) African studies are mainly North African, but Sub-Saharan Africa is not to be outdone. Our aim was to describe diagnostic and therapeutic features of NB in a Senegalese series collected in Dakar. This was a descriptive and retrospective study conducted at the Neurology department of Fann Teaching Hospital in Dakar, Senegal. All patients who met the NB's diagnostic criteria were included. Sixteen patients were collected, 14 males and 2 females with an average age of 40 years [18-71]. The main neurological signs were motor deficit (13 cases), headache (10 cases), and language disorders (4 cases). Extra-neurological signs were dermatological (14 cases), ocular (2 cases), and articular (2 cases) with aseptic unilateral gonarthritis. Fever was present in 9 patients. Neurological involvement was mostly isolated parenchymal (8 cases) or mixed (6 cases). The main clinical forms of NB were rhombencephalitis (8 cases) and retrobulbar optic neuritis (4 cases). Seven patients had a cerebral angio-Behcet with cerebral venous thrombosis (3 cases), ischemic stroke (2 cases), and intracerebral hematoma (2 cases). Under prednisone (16 cases) and azathioprine (3 cases), the short-term clinical outcome was mostly favorable (14 cases) with a modified Rankin scale at 2. NB is an under-diagnosed adult male disease in Sub-Saharan Africa and further studies are needed.

Guillain-Barre Syndrome (GBS) is an acute autoimmune polyradiculoneuropathy, that often follows an antecedent infection. Leishmaniasis is a zoonosis due to a flagellate protozoan of the Leishmania genus and transmitted by the sandfly. Here we report a 15 years old teenager who presented with an ascending installation of the motor deficit in three weeks associated with dysphonia and swallowing disorders. The physical examination showed a flaccid proximo-distal quadriparesis, akinesthesia, apallesthesia and cutaneous lesions on the forehead, wrist and calf that appeared two months earlier. The HIV serology was negative and cerebro-spinal fluid examination was normal. The electroneuromyography showed a reduction in motor and sensitive amplitudes with an increase in distal latencies and F waves in the upper limbs and segmental and focal conduction blocks. Parasitological examination of the dermal juice around the edges of the skin lesions revealed amastigote forms of leishmaniasis. The evolution was favorable with only symptomatic treatment.

Summary: Urinary disorders are frequent in spinal cord injury and complications make prognosis restricted and alter the quality of life. Early and adaptative managment improve quality of life. But in developping contry, so many diffcults make this managment late, and ofen limited. The aim of our study was to evaluate our management in urinary disorders associated of spinal cord injury. Patients and methods: A prospective study was done at the departments of Physical medicine and Neurology in the teaching hospital, Fann, Dakar Senegal. Were included, all patients with urinary disorders concomittent of a spinal cord injury. Patients with others diseases which can explain the urinary symptoms ,were excluded. After determine the Urinay symptoms (Urinary symptoms profile scale) and quality of life (qualiveen short form), patients meet the specialist of rehabilitation who establish type of management of urinary disorders. Secondly patients were received in a variable time, for apreciation evolution. Results: 39 patients were included. Mean of age was 42,7 years and sex ratio (H/F) 1.6. Dysuria associated of overactive badders (38,46%) and overactive bladers (28,20%) dominate the symptoms. Urinary infections (15.4%) were the common complications. Risk factors of alteration of quality of life were overactive blader and leaks during physical effort . The overage decline was 2.7 years. Quality of life was improved by Alfuzozine in all patients with score dysuria under 0,63 and by Oxybutinine in 64.3%. 5 patients benificed of perineal rehabilitation. Permanent catheterization noted in 17.9% of cases. Discussion and conclusion: Our results are similar of the litterature according for symptoms and risk factor of alteration of quality life. Drugs treatment can improve the quality of life. Intermittent catheterization is difficult in our practice.

to assess : the frequency of emergencies among patients admitted to dermatology departments in Dakar, their most common causes, mortality rate, and the most frequent dermatoses. This one-year prospective study took place in the two reference departments for the treatment of dermatological diseases in Dakar. We have included all patients with a dermatological emergency, regardless of age and gender, as determined by the doctor receiving the patient. The data were entered in Excel and analyzed with R software, version 3.1.2. the study included 189 patients, 40 % of all dermatology department admissions. The sex ratio was 0.89 (M/F) and the average age 49 years. The mean time from arrival to treatment was 30 minutes. Absolute emergencies accounted for 45.4 % of these emergencies, and relative emergencies 54.6 %. Absolute emergencies were dominated by severe drug eruptions (17 %) and relative emergencies by infectious dermatoses (38 %). Emergency measures were carried out in all cases, associated with etiological treatment. The mortality rate was 7 % (n=14), and 5 (36 %) of these deaths were due to severe drug eruptions. Infectious dermatoses and severe drug eruptions are the most frequent emergencies. The high mortality rate, related mostly to drug eruptions, indicates the need for early management and an adequate technical platform.

Nervous localisations of schistosomiasis are rare. We report the case of a 25 year-old Senegalese patient admitted for a progressive myeloradiculitis onset, over a one week period. The diagnosis of Schistosoma haematobium myeloradiculitis was made in front of a positive serum serology for S. haematobium, presence of S. haematobium eggs in urine, hyperproteinorachia, endemicity of S. haematobium in the region where the patient was originating and a past medical history of macroscopic hematuria in a context of river bathing. There was also no arguments for another cause to these neurological manifestations. Our patient was treated with praziquantel, prednisone and physiotherapy. Evolution was marked 6 weeks after the beginning of treatment by a significant improvement of motor deficit, enabling the patient to walk again. There was also a regression of genitosphincter dysfunction. Work-up for patients presenting with paraplegia in tropical countries, should also include search for S. heamatobium infection.

Introduction La decouverte des anticorps anti-AQP4 a fait adopter l’appellation « NMO spectrum disorder ». Les publications africaines qui lui sont dediees sont rares ou portent sur des cas isoles. Objectifs L’objectif etait d’analyser les caracteristiques des maladies du spectre NMO dans une serie senegalaise colligee a Dakar. Patients et methodes Il s’agissait d’une etude retrospective a visee descriptive (Avril 2011–Janvier 2018) menee a la Clinique de Neurosciences Ibrahima Pierre Ndiaye du Centre Hospitalier National Universitaire de Fann de Dakar. Les patients obeissants aux criteres diagnostiques 2014 des maladies du spectre NMO etaient inclus (Wingerchuck et al., 2015). Pour chaque patient, nous avons recueilli les donnees cliniques, para-cliniques, therapeutiques et evolutives. Resultats Seize patients (4H/12F) etaient colliges avec un âge moyen de 30 ans. Dix patients presentaient un tableau de myelopathie associee a une nevrite optique retro-bulbaire (NORB). L’IRM spinale montrait une myelopathie cervicale etendue chez 6 patients et les potentiels evoques visuels une NORB chez 8. Les Ac-anti-AQP-4 etaient positifs chez 10 patients. Tous les patients ont eu une corticotherapie, associee a l’azathioprine (10 patients). L’evolution clinique a 3 mois etait favorable (87,5 %). Discussion Le nombre de cas colliges peut etre sous-estime puisque le recrutement s’est fait dans l’unique Service de Neurologie du Senegal. Les services de medecine interne, neurochirurgie et ophtalmologie peuvent recevoir des patients suspects de NMO, pouvant etre source d’errance diagnostique. Le manque de specialistes et l’inaccessibilite de l’IRM et aux dosages immunologiques font que la NMO reste sous-diagnostiquee au Senegal. Conclusion Cette serie est la premiere colligee a Dakar. Des etudes epidemiologiques multicentriques nationales et de la sous-region sont souhaitable afin de determiner les particularites africaines de la NMO.

In Niger, palliative care is a necessity in everyday medical practice. However, the setting up of structures and / or mobile teams specifically dedicated to palliative medicine still faces enormous challenges. Most patients who consult for non-communicable disease or specifically for tumors or other incurable illnesses as some neurological diseases come advanced stages, requiring palliative care whereas there is as yet no national structure specifically dedicated to palliative care. No domain of research in palliative care is developed in Niger. No specific scientific work on palliative care have been conducted and published in Niger. This testifies to the lack of promotion of this specialty in Niger. So the ignorance of palliative care, access to morphine and ordinary molecules fight against pain are a real obstacle to the practice of palliative medicine in Sakoira Integrated Health Center (Tillaberi) in republic of Niger.