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Percheron’s artery (PA) occlusion is an uncommon type of stroke involving paramedian thalamus and/or midbrain infarction. It accounts for 4-18% of all thalamic infarcts and 0.1-2% of all strokes. Its clinical manifestations are variable and its mode of presentation as Weber’s syndrome is exceptional due to the unusual clinical presentatio

Movement disorders have different prevalence in different regions and they are little studied in Africa.Evaluate the prevalence and determine the spectrum of movement disorders in the first specialized center in Senegal.It was a prospective study over on 18 months in adult outpatient clinic. Demographic, clinical, paraclinical data, including genetic test in collaboration with the Queen Square Institute of Neurology at UCL were collected.One hundred and thirty four patients were followed up, representing a prevalence of 4.7%. Men represented 56% for a sex ratio of 1.3. The mean age of population was 47.7 ± 18 years with limits ranging from 16 to 81 years. Eighty-one patients (60.4%) had hyperkinetic and 53 patients (39.6%) had hypokinetic movements. Twenty-nine patients (21.6%) had tremors and 18 (13.4%) had dystonic movements. Ataxia and choreic movements were respectively in 11 (8.2%) and 10 patients (7.5%). Twenty-four patients (17.9%) were from a first-degree consanguineous. A genetic test on saliva samples was done in 16 patients (11.9%) and confirmed Huntington's disease in 8 patients of 6 families. Parkinson disease was the most frequent etiology (32.8%) followed by essential tremor (12.7%) and psychogenic tremor in 7.5%. Stroke accounted for 6% of the causes of MD (tremor, ballism, dystonia, ataxia and parkinsonism) and no etiology was found in 9%.The spectrum of movement disorders is very heterogeneous with a non-negligible frequency and diverse etiologies in neurological practice in Senegal.

Introduction: Febrile seizures are seizures associated with fever in children. They represent a frequent reason for consultation in pediatric emergencies. Febrile convulsions are often qualified as benign pathologies but they are a source of concern, explaining the number of tolls imposed on these children. The aim of the study was to report the practice to a hospital in Senegal. Materials and Methods: This is a retrospective study of children's records, from January 1, 2015 to January 31, 2020. Were included, patients aged less than or equal to 5 years, hospitalized in the pediatric department of the Ziguinchor Peace Hospital, for a febrile convulsion. Newborns and children with psychomotor development abnormalities were excluded. We have studied the clinical and etiological data. Results: We collected 85 (51 boys, 34 girls) cases of febrile convulsions, ie a hospital frequency of 10,6%. The mean age of the patients was 23,6 months, peaking in infants 12 to 18 months. The mean temperature was 38,8° C and the seizure was tonic-clonic in 64,7%. We noted 57 cases of simple febrile convulsions (67,1%) and 28 cases of complicated febrile convulsions (32,9%). The etiology of fever was dominated by otorhinolaryngologic infections (42,4%); malaria (18,8%) and bronchopulmonary infections (08,2%). The average length of hospital stay was 02,8 days. We deplored two deaths (02,4%). Conclusion: Febrile convulsions are common in children under 5 years old. They are secondary to respiratory tract infections and malaria.

Introduction: Hearing impairment is the most common sensory deficit at birth. It is a public health problem because of the repercussions on the communication development, on the education and subsequent social integration of the child. The objective of this study was to determine the epidemiological, clinical, audiometric and etiological profiles of child deafness in Casamance, South of Senegal. Materials and Methods: This was a retrospective multicenter study, which extended a period of 7 years from January 1st, 2012 to December 31st, 2019. All children aged between 1 to 18 years old and received during their first ENT consultations at the regional and PEACE hospital in Ziguinchor were included. Results: One hundred and seventy-eight records of children were collected during this period, that is a prevalence of 1.30%. The average age was 9 years old. Conductive hearing loss was found in 68% of patients, followed by reception hearing deafness in 24%. The deafness was acquired in the majority of cases (93%) and the predominant etiology was infectious. However, the cause was unknown in 7.51% of cases. Conclusion: Child deafness is common in Casamance and is most often underdiagnosed. The acquired forms are the most common, hence the importance of early detection after a rigorous family investigation.

ntroduction: Stroke according to the WHO (World Health Organization) is a sudden deficit of focal brain function with no apparent cause other than a vascular cause. It is a major public health problem. It is the first cause of motor disability, second cause of cognitive disability and third cause of mortality in the world. Material and method: It is a retrospective and descriptive study of a period of 18 months (January 1, 2016 to October 30, 2017) conducted in the national Emergency Medical Services of Dakar (Senegal). According to our study criteria, 343 patients were collected. Results: The mean age of the patients was 64.2 years (extremes of 17 and 104 years). Men represented 54.22% (sex ratio M/W 1.8). Dakar represented the main provenance of our patients (79.30%). Hypertension was the main risk factor (50%). Acute headaches were the main warning sign (13.41%). An echocardiography was performed in 59 patients; complete tachyarrhythmia by atrial fibrillation represented 30% of the ECG. The CT-scan was performed for 201 patients (61% of ischemic stroke, 37.5% hemorrhagic and 1.5% of transient ischemic attack). The medevac represented 53.93%. Transportation was made essentially by the emergency medical services; home interventions were the most represented. The mean time for intervention by the emergency medical services was 134.71 minutes. Fann Hospital was the main host structure (45.49%). The care (of the emergency medical services) included, among others, intubation (4.8%), monitoring, oxygen therapy, urinary catheter and medical treatment. We noticed 20.40% of deaths in our series, due essentially to neurological complications. Conclusion: Stroke is a major public health problem. Difficulties are sometimes encountered in the care and the research of an appropriate host structure. The purpose of the pre-hospital care is to intervene as soon as possible while making a clinic diagnosis by performing forthwith a brain CT-scan in order to optimize the care and improve the prognostic of stroke patients.

The photoparoxysmal response (PPR) is defined as the occurrence of generalized spike, spike-wave or polyspike-wave discharges consistently elicited by intermittent photic stimulation (IPS). PPR is not well studied in Sub-Saharan African people. We prospectively studied the epidemiological, clinical, and EEG characteristics of PPR among consecutive patients recorded at the clinical neurophysiology unit of Fann University Hospital (Dakar, Senegal). Among 6,808 EEG recordings including 3,065 pathological EEGs, we collected 56 EEGs with PPR (0.8% of all recorded EEGs and 1.8% of anormal EEGs), from 31 women and 25 men (sex ratio: 0.8). The mean age was 13.3 years (range: 8 months to 59 years). The peak of photosensitivity was found in the range of 6 to 10 years. Of the PPR cases, 12 had clinical manifestations during IPS. Generalized epilepsy was diagnosed in 23 (41%) patients and 18 (32%) had focal epilepsies. The most epileptogenic stimulation frequencies were between 12 and 24 Hz (range: 1-28 Hz). PPR were mainly triggered during eye closure (64%), and 41 patients (73% of PPR cases) were classified as Type 4 (Waltz classification). Our results confirm lower rates of photosensitivity in African Sub-Saharan people compared with others. Although the current data do not support a role of short-term ambient light levels, subject to consistent data from larger cohorts, it may be interesting to study the probable epigenetic-mediated protective role of sunshine against photosensitivity.

We report a case of metastasis to the gingiva of breast carcinoma. The breast tumor was treated with neoadjuvant chemotherapy followed by a radical mastectomy associated with axillary dissection. The gingival lesion occurred 7 months after surgery; the metastasis was confirmed by a biopsy., This case is not an obvious diagnosis. We therefore recommend a biopsy for any chronic gingival mass in the context of previous malignancy.

Calcium and magnesium are divalent multipotent ions playing a major role in metabolism, excitability and neuroglial plasticity. Because of these multiple properties, their deficiency induces complex brain processes leading to acute or even lasting disorders in excitability and neural networks. These ions are usually prescribed in clinical contexts of neuronal hyperexcitability such as preeclampsia and chronic stress. Our aim was to evaluate whether magnesium at 20 mg/kg and calcium at 100 mg/kg could improve the memory prognosis in the kainic model of mesial temporal epilepsy in mice. The animals were organized into 6 groups: control group (without kainate), reference group (GR) without administration of ions, groups treated with magnesium or calcium from the third day (respectively G1m, G1c), groups treated with magnesium or calcium from the third week (respectively G2m, G2c). The mice treated by ions performed better than GR mice, but magnesium was more effective. Memory (short term-long term) was differently affected by kainate or improved by magnesium-calcium. In addition, magnesium demonstrated an increasing therapeutic effect over time while calcium had an acute and apparently decreasing action in the G1c group that received calcium early.

The anodizing of AS12 alloys in various alkaline media is investigated over a large potential range (0–600 V) in order to provide a deep understanding of the mechanisms involved and judiciously chose chemical conditions enabling efficient micro-arc anodizing. Combined in situ stationary electrochemical methods, electrochemical impedance spectroscopy and TEM observations reveal that silicon in the aluminium matrix modifies the composition and the electrochemical properties of the duplex nanostructure grown at the early stages of the anodizing, therefore hindering micro-arc anodizing initiation. The addition of fluorides to the electrolyte, or silicates to a lesser extend, reinforces the resistive properties of the internal anodic layer and favors the efficiency of the anodizing process. The corrosion resistance of AS12, evaluated in NaCl 0.1 M by electrochemical techniques and salt spray test, is improved by the presence of the oxide coating and the nature of the additive incorporated compounds as well.

Introduction: No-trauma spinal cord compressions are serious conditions not often described in children population. This study will discuss the epidemiological, clinical, biology and radiology assessment, the etiologies, the therapeutic and evolutionary aspects of this condition in children in Senegal. Patients and Methods: 113 children aged between 15 months and 18 years were managed in a 10 years period (from January 2005 to July 2015) for a non-traumatic spinal cord compression (average 8.3 years). Results: There was 66 males (58%) and 47 females (42%) with sex ratio of 1.40. The main reasons for consultation were spinal deformity (90 %). The syndrome was complete in 52 patients (46%) and incomplete in 61 patients (54%). Plain radiography performed in 63 patients. The CT scan was performed in 21 patients and myelography performed in 4 patients. MRI was performed in 22 patients. There was intradural extramedullary process (33.33%), the extradural lesions (14.28%) and intramedullary process (28.57%). Dorsal lesions were predominant (46%) followed by the lumbar spine (27%). The majority of the etiology was Pott’s disease (80%) followed by tumors (17%). Spondylitis to banal germs (2%) and parasitic spinal cord compression (1%) were rare. The histology of 6 patients was revealed 5% neurofibroma Type II, 5% extramedullary intradermal arachnoid cyst, 5% intramedullary arachnoid cyst with cytochemistry of the CSF—like content, 5% Anaplastic pilocytic astrocytoma, 5% ganglioneuroma I terminal cone and 5% meningothelial meningioma. Pott’s disease has been cured by TB chemotherapy associated with a corset in 88.89% of cases. 2 patients of this group had benefited fixation after laminectomy. 68% of the patients had a favorable recovery, and 20% had completely recovered after an average of 7 months of treatment and three (3) patients had died. The compression by bilharzias is be cured by myelotomy and praziquantel with a favorable outcome. We have 94.74% decompressive laminectomy or laminotomy with tumor resection and four (4) Patients of this group benefited fixation; the patients who had intramedullary tumor benefited myelotomy and tumor resection; 3 patients in this group had benefited fixation after laminectomy 58% of patients had good recovery and 1 pateint had died. Conclusion: In Africa, particularly in the tropics, Pott’s disease remains the first etiology followed by vertebra-medullary tumors for no traumatic spinal cord compression of child.

Background and Aims: Initially barely affected by the COVID-19, the African continent suffered a second violent wave this winter. Neurological manifestations worldwide are increasingly reported, dominated by encephalitis, stroke and polyradiculoneuritis. We report the Senegalese experience of Neurocovid through a series of 9 patients. Methods: This is a prospective study of patients hospitalized in the neurology department of Fann. Were included patients who had neurological manifestations during or following an COVID-19 infection defined by a positive PCR or a recent infection with ELISA serology or typical chest imaging. Results: We collected 9 patients (6 men and 3 women), aged 7 to 80 years. Diagnoses were: 3 encephalitis, 4 polyradiculoneuritis, 1 hemorrhagic stroke and 1 chorea. 4 patients had comorbidities. The delay for neurological signs appearance was 11.1 days. A nasal swab was positive on 5/8 patients. Antibodies were found in all 3 negative patients. The LCR study showed hyperproteinorrachia in 7/9 patients. 5 patients underwent CT chest scan, showing ground glass opacities. Brain imaging was normal in 3 and pathological in 2, showing a parietal temporo hematoma fx1 in one and mesencephalic and parietal hypersignal in the other fx2 50% of patients with polyradiculoneuritis had an ENMG that showed an AIDP. One patient had an electroencephalogram that showed an overall slowing of the pattern with diffuse pseudoperiodic complexes fx3. Evolution was good for 6 patients but we noticed 3 deaths. [Formula presented] [Formula presented] [Formula presented] Conclusions: Neurological manifestations most often occur in post-infection. The creation of a multidisciplinary team will allow a better understanding of the sequel as of patients with COVID-19.

Les lésions du nerf laryngé inférieur représentent les complications les plus dévastatrices de la chirurgie thyroïdienne. L'identification du nerf laryngé inférieur est d'autant plus difficile que son trajet est atypique. Nous rapportons un cas de nerf laryngé inférieur droit non récurrent découvert à l'occasion d'une thyroïdectomie.

L´épilepsie pose un problème de santé publique au Sénégal. L´objectif de l´étude était de décrire les aspects cliniques et paracliniques de l´épilepsie de l´enfant à l´Hôpital de la Paix de Ziguinchor (HPZ). Il s´agissait d´une étude documentaire de dossiers d´enfants épileptiques, du 1erjanvier 2015 au 31 décembre 2018. Ont été inclus, les patients âgés ≤ de 15 ans, suivis pour épilepsie à l´HPZ. Etaient exclus, les dossiers incomplets. Cinquante-cinq (37 garçons et 18 filles) enfants ont été colligés; 70,9% avaient un âge < à 5 ans. L´âge moyen était de 4,3 ans. Les patients étaient originaires du milieu rural (60%) et de famille défavorisée (67,3%). Les crises d´épilepsie étaient généralisées (72,7%) et focales (27,3%). Dix-huit patients présentaient une épilepsie idiopathique, 17 une épilepsie non idiopathique. Les facteurs étiologiques étaient dominés par les anomalies de la grossesse et de l´accouchement (29,1%). L´épilepsie est fréquente à l´HPZ. Elle prédomine en milieu rural chez les garçons de moins de 5 ans, issus de famille défavorisée. Les crises généralisées tonico-cloniques et les crises focales sont les tableaux cliniques les plus fréquentes et les anomalies de la grossesse et de l´accouchement sont les étiologies les plus retrouvées.

Introduction:le Papillome Inversé (PI) est une tumeur bénigne nasosinusienne rare caractérisée histologiquement par une invagination de l'épithélium de surface dans le chorion sous-jacent. Elle se distingue par une forte agressivité locale, une tendance à la récidive et par son risque imprévisible d'association à un carcinome épidermoïde. L'objectif de l'étude était de rapporter les données épidémiologiques, cliniques, paracliniques ainsi que d'évaluer les résultats de la chirurgie endoscopique endonasale. Méthodes:il s'agit d'une étude rétrospective portant sur une série de 13 patients colligés au Service d'Oto-Rhino-Laryngologie du Centre Hospitalier National Universitaire de Fann, du 1erjanvier 2012 au 31 décembre 2017. Ont été inclus dans l'étude tous les patients suivis pour un papillome inversé confirmé à l'examen anatomopathologique. Résultats:l'âge moyen de nos patients était de 44 ans et le sex-ratio (H/F) de 2,25. Tous les patients avaient présenté une obstruction nasale alors que la rhinorrhée était présente dans 53% des cas suivis de l'épistaxis dans 30% des cas. La symptomatologie était latéralisée à droite dans 69% des cas, 23% à gauche et 7% de façon bilatérale. La rhinoscopie antérieure avait permis de visualiser une masse endonasale chez tous les patients. Tous les patients avaient bénéficié d'une TDM; l'IRM avait été réalisée chez un seul patient. L'exérèse du PI par voie endoscopique endonasale avait été effectuée chez 10 patients (76,9%) alors que la voie externe avait été utilisée dans 23% des cas. La chirurgie avait permis de préciser la base d'implantation de la tumeur qui était de l'ordre de 46% dans le sinus maxillaire, 15% dans le cornet inférieur, 15% dans le cornet moyen, 7% dans la bulle ethmoïdale et 7% dans la paroi latérale de la fosse nasale. Un patient avait eu une récidive du papillome inversé après un délai moyen de 26 mois. L'association maligne s'était révélée par un cas de dégénérescence maligne en carcinome épidermoïde. Conclusion:le papillome inversé est une tumeur très agressive. La TDM fournit beaucoup de renseignements à propos de son extension, surtout osseuse. Le traitement est actuellement révolutionné par la chirurgie endoscopique qui offre d'excellents résultats. Mais, il existe néanmoins un risque de récidive après chirurgie qui doit motiver une surveillance au long cours.

Les accidents vasculaires cerebraux ischemiques de l’enfant ne sont pas rares et font partie des 10 premieres causes de deces en pediatrie. Malgre la plasticite cerebrale, des deficits neuropsychiques plus ou moins importants persistent souvent chez les survivants. Les etiologies sont multifactorielles et sont dominees par les arteriopathies et les cardiopathies. En Afrique, les principaux facteurs de risque sont la Drepanocytose, les cardiopathies rhumatismales et les infections du systeme nerveux central. La prise en charge s’inspire de ce qui se fait chez l’adulte mais la systematisation de la thrombolyse reste discutee du fait du risque hemorragique et de l’existence de peu de donnees publiees. La prevention primaire et secondaire reste importante du fait du risque de recidives, particulierement eleve dans les arteriopathies et les cardiopathies.

Introduction: Ballistic trauma is the consequence of the penetration into the body of a projectile (bullet, lead, metal fragment) coming from the envelope or the contents of an explosive device. Case Report: We report the case of a 16-year-old patient with no particular pathological history that we had received for a ballistic trauma to the upper cervical spine that occurred in Conakry. The neurological examination was normal. Cranio-cervical imaging revealed the presence of a projectile at the level of the left condylo-atloid joint with fracture of the internal cortex of the ipsilateral condyle. The aim of the surgery consisted of a laminectomy associated with removal of the projectile and exploration for vascular complications and osteomeningeal breaches. The operative consequences were simple. Conclusion: Ballistic trauma is a complex, infrequent but serious clinical entity. Their management must obey a well-codified strategy.

Introduction La photosensibilite est un phenomene anormal detecte sur l’electroencephalogramme (EEG) pendant la stimulation lumineuse intermittente (SLI) sous forme de decharges epileptiques ou reponse photoparoxystique (RPP). Objectifs Mise a jour des donnees recentes sur la photosensibilite humaine en Afrique noire car tres peu de travaux sont reportes et notamment au Senegal. Patients et methodes Une etude prospective sur les caracteristiques epidemio-cliniques des patients epileptiques presentant une RPP vu au CHU de Fann de Dakar. Resultats Sur 3065 EEG de patients epileptiques de l’annee 2016, 56 EEG (1,8 %) presentaient une RPP, avec un sexe ratio : 0,8. L’âge moyen etait de 13,3 ans, pour des pics de photosensibilite entre 6 et 10 ans. L’epilepsie etait generalisee chez 23 (41 %) des patients et focale chez 18 (32 %). Les frequences de stimulation les plus epileptogenes etaient comprises entre 12 et 24 Hz. La RPP a ete obtenue le plus souvent lorsque les yeux sont fermes chez 64 % patients et 41 patients (73 % des patients) ont ete classes dans le type 4 (classification de Waltz). Discussion En Hollande, en Allemagne la RPP est retrouve chez 5 a 8 % des patients epileptiques, contre seulement 1 a 2 % au Nigeria ou au Zimbabwe. Des auteurs ont retrouve des frequences de SLI epileptogenes maximum entre 10 et 25 Hz. RPP liees aux epilepsies generalisees idiopathiques sont constatees dans pres de 50 % des cas. Conclusion La photosensibilite est plus faible chez les patients noirs subsahariens comparativement aux Caucasiens. Il serait interessant de faire une etude de cohorte multicentrique afin d’etudier la valeur epigenetique protectrice probable de l’ensoleillement sur cette forme d’epilepsie.

Introduction En Afrique les expositions toxiques sont fortement liees aux activites economiques des populations. Objectifs Faire une revue exhaustive des intoxications en Afrique. Patients et methodes Revue bibliographique detaillee des publications faites sur le sujet. Resultats Les zones auriferes avec l’utilisation du mercure dans l’orpaillage traditionnel, l’intoxication au plomb de certaines populations qui extraient le plomb des batteries des voitures, l’usage incontrolee des pesticides dans les zones rurales et peri-urbaines constituent les principales sources d’intoxication. La pharmacopee traditionnelle est une autre source d’intoxication des populations pauvres. Les grandes metropoles sont quant a elles confrontees a la pollution de l’air et a la montee des drogues urbaines dans la jeunesse. Discussion Les investigations biologiques se heurtent souvent a l’absence de laboratoires specialises et la prise en charge reste imparfaite du fait du contexte socio-economique et du profil de ces intoxications. La prevention demeure l’instrument privilegie des politiques publiques et doit reposer sur l’information et l’education des populations. Conclusion Les changements climatiques et les bouleversements lies aux grandes mutations socio-demographiques incitent a des politiques publiques plus volontaristes.