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Introduction La plus commune des ataxies hereditaires est l’ataxie de Friedreich (AF). Elle serait plus frequente dans la population caucasienne avec tres peu de donnees disponibles sur sa prevalence au Sub-Sahara. Objectifs Nous aimerions evaluer la prevalence et les caracteristiques de l’AF au Senegal. De meme, l’etude nous permettra d’effectuer une comparaison avec les donnees de la litterature. Patients et methodes Nous avons complete une etude retrospective de tous les patients hospitalises pour AF du 1er janvier 1960 au 31 decembre 2004 a la clinique neurologique de Dakar qui est le principal centre neurologique du Senegal. Seuls, les patients diagnostiques par un neurologue ont ete enroles dans l’etude. La conduction nerveuse a ete evaluee par electromyographie. Une biopsie neuro-musculaire a ete effectuee sur 10 participants. Resultats Nous avons obtenu 34 cas d’AF, 62 % d’hommes (21/34), 41 % âges de moins de 20 ans (14/34) et une prevalence approximative de 1/300000. Le nombre de cas de deficit moteur, de trouble de la sensibilite et d’ataxie aux membres etaient respectivement 15/32 (47 %), 9/32 (28 %) et 10/32 (31 %). A l’electromyographie nous avons note une atteinte axonale (6/19) et des potentiels evoques somesthesiques anormaux (7/19). La moitie des biopsies musculaires ont montre une atrophie neurogene. Discussion Dans notre cohorte, la prevalence de l’AF etait six fois plus faible que dans la population caucasienne (1/50000). Cela est partiellement attribue a l’influence de la medecine alternative au Sub-Sahara. L’expression de l’AF etait moindre, tel que deficit moteur (47 % versus 88 %) ou pied creux (18 % versus 52 %). Aussi, nous notons une difference socio-ethnique telle que la pratique de l’endogamie. Conclusion Notre prevalence de cas d’AF est faible. La symptomatologie etait moindre au Senegal comparativement a la population caucasienne. Cependant, la conscientisation de la population autour des facteurs socio-ethniques est necessaire.

The purpose of this study is to report our experience on Pott's disease in Senegal, which belongs to the group of least-developed countries .In these countries, tuberculosis is still a public health issue. Regarding spine tuberculosis, we attempted to implement a diagnostic and therapeutic approach appropriate for our conditions of medical practice. The authors reported a retrospective epidemiological and clinical study of 255 patients suffering from tuberculosis of the spine. Theses patients were hospitalized at the University Hospital of Fann in Dakar from January 1986 to July 1998. Sixty percent came from the capital, the mean age was 34.9 years, there were 136 males for 119 females, and antituberculosis immunization were not done every time. Associated extra-spinal tuberculosis, predominantly tuberculosis of the lung, was observed in 28.2 patients (59%). Of 37 patients tested for human immunodeficiency virus (HIV) infection, only one was positive. Patients came late to the hospital, leading to a high percentage of neurological complications (79.2%). Our diagnostic strategy was based on epidemiological and clinical criteria already defined by Martini. Thoracic spine (53.8%) and lumbar sacral spine (21.7%) were the column vertebral segments most frequently involved. All patients received antituberculosis chemotherapy, and only 39 patients underwent surgery with laminectomy without posterior instrumentation. Functional outcome study was done for 89 paraplegic patients: 26 (29%) went to Frankel grade D or E and, among 27 operated patients, nine entered theses grades. Seventeen patients (11.5%) died. We developed the concept of "spinal-cord rescue," which focuses more on neurological rather than biomechanical issues.

Objective Therefore, the aim of our study was to determine risk factors for poor quality of life by considering disability after stroke in its multidimensional aspects but also to see the impact of each risk factor on the dimensions of quality of life. Material/Patients and methods A prospective study of stroke patients confirmed, followed by neurovascular consultation at Fann Hospital in Dakar has been achieved. Quality of life was evaluated by the 65 Sikness Impact Profile (SIP 65), the depression by the scale of Beck. Results We included 70 men and 30 women with a mean age of 55.25 years. The education rate was 56.12%. Hypertension (65%); musculoskeletal diseases (26.26%) were the major associated defects. Ischemic stroke was predominant. Depression was observed in 53% of cases. The outputs of the house and in the city were respectively arrested in 50% and 73% of cases. Most of the patients, 61%, were conducting any activity at home. Age was associated with an orientation problem in time significantly ( P = 0.02), musculoskeletal diseases to need help dressing ( P = 0.03); the degree of disability to need help to sit and sleep ( P = 0.00003), a lack of sleep the night ( P = 0.00002) and a home asset; depression suffering of sexual life ( P = 0.002), a shortened working time ( P = 0.005) and reduced leisure time ( P = 0.0004). Discussion - Conclusion The sedentary post stroke Senegalese patients can’t be explained solely by altering the physical dimensions of quality of life. All the more that disability assessed by the Barthel showed that locomotion is possible in over 50% of cases.