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This case suggests that clinicians should consider seizures as a differential diagnosis of paroxystic cough with loss of consciousness. Focal cortical dysplasia should equally be screened for with magnetic resonance imaging (MRI) scans even in adults with epilepsy in sub‐Saharan Africa. This case suggests that clinicians should consider seizures as a differential diagnosis of paroxystic cough with loss of consciousness. Focal cortical dysplasia should equally be screened for with Magnetic Resonance Imaging (MRI) scans even in adults with epilepsy in sub‐Saharan Africa. [ABSTRACT FROM AUTHOR]

Background. Sleep apnea syndrome (SAS), a growing public health threat, is an emerging condition in sub-Saharan Africa (SSA). Related SSA studies have so far used an incomplete definition. This study is aimed at assessing SAS using an American Academy of Sleep Medicine (AASM) complete definition and at exploring its relationship with comorbidities, among patients hospitalized in a Cameroonian tertiary hospital. Methods. This cross-sectional study was conducted in cardiology, endocrinology, and neurology departments of the Yaoundé Central Hospital. Patients aged 21 and above were consecutively invited, and some of them were randomly selected to undergo a full night record using a portable sleep monitoring device, to diagnose sleep-disordered breathing (SDB). SAS was defined as an apnea − hypopnea index AHI ≥ 5 /h, associated with either excessive daytime sleepiness or at least 3 compatible symptoms. Moderate to severe SAS (MS-SAS) stood for an AHI ≥ 15 / h. We used chi-square or Fisher tests to compare SAS and non-SAS groups. Findings. One hundred and eleven patients presented a valid sleep monitoring report. Their mean age ± standard deviation (range) was 58 ± 12.5 (28–87) years, and 53.2% were female. The prevalence (95% confident interval (CI)) of SAS was 55.0 (45.7, 64.2)% and the one of MS-SAS 34.2 (25.4, 43.1)%. The obstructive pattern (90.2% of SAS and 86.8% of MS-SAS) was predominant. The prevalence of SAS among specific comorbidities ranged from 52.2% to 75.0%. Compared to SAS free patients, more SAS patients presented with hypertension (75.4% vs. 48.0%, p = 0.005 %), history of stroke (36.7% vs. 32.0%, p = 0.756), cardiac failure (23.0% vs. 12.0%, p = 0.213), and combined cardiovascular comorbidity (80.3% vs. 52.0%, p = 0.003). Similar results were observed for MS-SAS. Metabolic and neuropsychiatric comorbidities did not differ between SAS and SAS-free patients. Conclusion. The SAS diagnosed using modified AASM definition showed high prevalence among patients hospitalized for acute medical conditions, as it was found with SDB. Unlike HIV infection, metabolic and brain conditions, cardiovascular comorbidities (hypertension and cardiac failure) were significantly more prevalent in SAS patients. [ABSTRACT FROM AUTHOR]

Epilepsy affects at least 50 million individuals worldwide, especially in sub-Saharan Africa (sSA). Cognitive impairment is common in people with epilepsy (PWE) yet, little is known on the burden of cognitive impairment in people with epilepsy in sSA. This study was thus designed to assess cognitive impairment in PWE or epilepsy-associated neurocognitive disorders (EAND) in a rural population in Cameroon. This was a case–control study including PWE and age/sex-matched healthy controls from July to September 2017 in Bilomo, a village in the Mbam and Kim Division. The Montreal Cognitive Assessment (MoCA), International HIV Dementia Scale (IHDS), Dubois' Five Word testing, Frontal Assessment Battery (FAB), Isaac's Set Test and the Clock drawing test were administered to the study participants to evaluate global and specific cognitive functions. Eighty participants were included (40 cases and 40 controls) with a mean age of 25.78 years. Using the MoCA, 87.5% of cases had cognitive impairment, against 37.5% of controls (p < 0.001; OR 11.67; CI 3.40–45.09). Using the IHDS, the prevalence of global cognitive impairment was 84.6% among the cases against 40% for the controls (p = < 0.001; OR 7.07; CI 2.29–29.19). Specifically, executive function deficits (92.5% of cases vs 40.0% of controls p = < 0.001 OR = 18.50 CI; 4.48–105.08) and decreased verbal fluency (100% of cases against 45% of controls p < 0.001) were the most affected cognitive domains. Longer duration of epilepsy and higher seizure frequency were associated with global cognitive impairment. Low level of education was associated with both decreased verbal fluency and executive dysfunction while a longer stay in Bilomo correlated with poor results on the Isaac's Set Test. The prevalence of cognitive impairment appears to be much higher in PWE in the Mbam valley, particularly decreased executive function and verbal fluency, than in people without epilepsy. Longer disease duration, higher seizure frequency, low level of education and length of stay in Bilomo are associated with poorer cognitive performance. More studies are needed to refine evaluation tools to better characterize and manage EAND in sSA. Fig. 2 Correlation test between duration of epilepsy and global cognitive performance. There was a significant negative correlation on the Spearman's correlation test between duration of epilepsy and global cognitive performance both with the IHDS (r = − 0.342 p = 0.036) and MoCA (r = − 0.139, p = 0.048); Fig. 2A and B respectively. Unlabelled Image • The burden of cognitive impairment in people with epilepsy (PWE) in Africa is poorly known. • We studied epilepsy-associated neurocognitive disorders (EAND) in a rural onchocerciasis-endemic population in Cameroon. • Significantly more PWE (80–100%) than controls (37–45%) had cognitive impairment. • Executive function deficits and decreased verbal fluency were the most affected cognitive domains. • Longer duration of epilepsy and higher seizure frequency were associated with global cognitive impairment in PWE. • Low level of education was associated with both decreased verbal fluency and executive dysfunction in the rural population while a longer stay in Bilomo correlated with poor results on the Isaac's Set Test. [ABSTRACT FROM AUTHOR]