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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).

Tolosa–Hunt syndrome is a painful ophthalmoplegia characterized by recurrent unilateral orbital pain, ipsilateral oculomotor paralysis, and a rapid response to steroids. Our report describes a 37-year-old young woman who presented with right ptosis, ipsilateral ophthalmoplegia, and painful headache with no other neurological deficits in which all biological and neuroimaging investigations were normal. Complete recovery within one week of corticosteroid therapy was observed. This is probably the first case of Tolosa–Hunt syndrome reported in Dakar, Senegal.

International audience; Objective: To assess the availability of health workers and medications for clinical management of amyotrophic lateral sclerosis (ALS) in African hospital centers. Availability and affordability analyses of disease-modifying treatments were performed. Methods: A multicenter observational study involving African hospitals was conducted. A standard questionnaire was developed based on the European Federation of the Neurological Societies (EFNS) guidelines. We collected data on multidisciplinary care and availability of medicines. The availability and affordability were evaluated according to the WHO guidelines. Results: Nine hospital centers from eight African countries participated. We observed a low degree of implementation of multidisciplinary care in ALS management. Riluzole was only available in centers from South Africa, Senegal, Tunisia, and Togo. This treatment was unaffordable and the adjusted price was highly variable among countries. The cost of riluzole was partly or fully covered by patients, which implies a substantial economic burden. Conclusion: Our findings strengthen the need to promote multidisciplinary care in the clinical management of ALS in Africa. Disease-modifying medication should be both available and affordable. Local and international collaboration is needed to improve ALS health care access in Africa.

Stroke represents the 2nd cause of mortality and 1st cause of physical disability in the adult population. In Senegal, it represents 30% of hospitalization and 2/3 of the mortality in the department of neurology in the capital city, Dakar. Objective: To specify the types of stroke and to evaluate diagnostic delays in Senegal’s regional hospitals. Materials and Methods: This was a retrospective, cross-sectional, descriptive, multicentric study for 4 years (from 2014 to 2017) including any patient presenting a clinical suspicion with a CT scan confirmation of stroke in one of the 9 regional hospitals in Senegal with a recruitment period of 6 months per hospital. CT scans were performed with a 16 slices machine in 6 hospitals, 4 slices in 2 hospitals and 2 slices in 1 hospital. We studied the types and location of strokes, the associated signs and the time from stroke onset to admission and the time from admission to CT scan. Results: 655 patients were retained including 322 men and 333 women for an M/F ratio of 0.96. The average age was 63 years (range: 7 years, 112 years). High blood pressure was noted in 59.2% of patients and diabetes in 10.7% of patients. Strokes were ischemic in 76% of cases involving the middle cerebral artery in 73% of cases and hemorrhagic in 24%, of which 80.7% were deep localized. A mass effect was noted in 7.5% of cases, an engagement in 6.9% of cases and ventricular hemorrhage in 2.7% of cases. The delay between the onset of the deficit and admission was less than 6 hours in 10.6% of patients. The time between the onset of stroke and admission to hospital was specified in 416 patients (63.5%) of the study population, it was less than 6 hours in 10.6% of patients, between 6 hours and 24 hours for 29.3% and more than 24 hours for 60.1%. Between admission and the CT scan, the time was precise in 459 patients (70%), it was less than 6 hours in 37.9%, between 6 hours and 24 hours in 43.6 % and more than 24 hours in 18.5%. Conclusion: CT is central to the diagnosis of stroke in rural areas. However, there is a significant delay in diagnosis and management.

Pursuing the objective of improving the photovoltaic penetration rate in an electric mix dominated by thermal energy, the integration of the demand response is solicited to absorb the fluctuations and intermittencies induced by the energy from PV. In the work presented in this article hybrid loads (LPG and electrical) participate in the demand response, offering the advantage of targeting a household activity not yet taken into account in the load profile, but also avoiding the report and rebound effects often seen in Demand Side Management. It will be a question here of evaluating the capacity for these loads to absorb the energy surplus of origin PV whose quantity exceeds at certain time the demand coming from the conventional loads.

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.

ObjectiveWe describe and compare the sociodemographic and clinical features, treatments, and prognoses and survival times of patients with amyotrophic lateral sclerosis (ALS) in Africa.MethodologyWe conducted a multicentre, hospital-based cohort study in Africa. Patients with ALS diagnosed in the neurology departments of participating hospitals from 2005 to 2017 were included. Subgroup analysis was performed by subcontinent. Survival analyses were conducted using the Cox proportional hazards model.ResultsNine centres from eight African countries participated. A total of 185 patients with ALS were included: 114 from Northern Africa, 41 from Western Africa and 30 from Southern Africa. A male predominance (male to female ratio 2.9) was evident. The median age at onset was 53.0 years (IQR 44.5–64.0 years). The onset was bulbar in 22.7%. Only 47 patients (26.3%) received riluzole, mainly in Northern and Western Africa. The median survival from the time of diagnosis was 14.0 months (95% CI 10.7 to 17.2 months). The median survival was longer in Northern Africa (19.0 months, 95% CI 10.8 to 27.2 months) than in Western (4.0 months, 95% CI 0.8 to 7.1 months) and Southern (11.0 months, 95% CI 5.6 to 16.4 months) Africa (Breslow test, pConclusionMore African patients with ALS were male and younger and exhibited a lower proportion of bulbar onset compared with patients with ALS from Western nations. Survival was consistent with that in Western registers but far shorter than what would be expected for young patients with ALS. The research improves our understanding of the disease in Africa.

Introduction L’accident vasculaire cerebral est une affection neurologique handicapante qui constitue un probleme de sante publique. Les patients travailleurs victimes de cette affection, sont confrontes a des difficultes de reinsertion professionnelle. Objectifs Analyser la reinsertion professionnelle des patients victimes d’un accident vasculaire cerebral. Patients et Methodes Il s’est agi d’une etude transversale, realisee a la clinique neurologique et au service de medecine physique et de readaptation fonctionnelle du CHU de Fann a Dakar, de septembre 2017 a mai 2018. Nous avons recueilli les caracteristiques socio-demographiques, les donnees relatives a l’AVC, les capacites fonctionnelles par l’echelle de Rankin modifiee et l’index de Barthel, l’existence ou non d’une depression. La reprise de travail et la nature du poste de travail ont aussi ete recherchees. Resultats Nous avons recrute 41 patients, dont l’âge moyen etait 52 ± 9,6 ans, avec une predominance masculine (73 %). Le taux de scolarisation etait 42 %. L’AVC ischemique etait note aupres de 30 patients (73 %). Seuls 13 patients (32 %) avaient repris le travail, un patient avait ete reclasse. Le delai de reprise de travail variait de 7 jours a 12 mois apres la survenue de l’AVC. La reprise de travail etait associee au sexe masculin (p Discussion Au CHU de Fann a Dakar, le sexe masculin, et la scolarisation sont significativement associes a la reprise de travail dans les suites d’un accident vasculaire cerebral. Mais, ce taux de reprise de travail apres l’AVC est faible, par rapport a la majorite des autres auteurs qui avaient realise une etude multicentrique. Conclusion Cette etude montre que l’AVC, affection neurologique grave et handicapante n’epargne pas les sujets exercant une activite professionnelle. Cependant, la reprise de travail reste possible chez certains patients. Informations complementaires Aucun financement.

Resume Introduction L’epilepsie est un probleme de sante publique pouvant influencer la vie sexuelle et vice versa. L’objectif de ce travail est d’etudier les consequences des antiepileptiques sur la vie sexuelle, la grossesse et l’allaitement des femmes epileptiques. Methodes Il s’agit d’une etude prospective, allant du mois de mars au mois d’aout 2011, a la clinique neurologique de Fann-Dakar Senegal et qui est orientee uniquement sur les femmes epileptiques. Resultats Nous avons collige 120 patientes âgees de 16–64 ans avec une moyenne d’âge a 30,58 ans, dont 45 % mariees. Parmi, 45,83 % presentaient une epilepsie generalisee. Quatre-vingt-dix pour cent avaient des troubles sexuels liees aux medicaments et 75 % menaient une vie sexuelle active. On notait une diminution du nombre de rapports sexuels durant la maladie [31/55 = 56,66 %]. Par ailleurs, 51,17 % ont eu a utiliser une contraception, dont 38,7 % de type orale. Parmi, 64,86 % avaient remarque une augmentation de la frequence des crises au moment de leurs grossesses. Parmi les 74 femmes qui avaient contracte une grossesse, 41,89 % avaient des enfants prematures, 16,21 % avaient fait des avortements et 61,17 % avaient une vie psychosociale affectee. Discussion et conclusion Les femmes epileptiques eprouvent des problemes sexuels, secondaire a l’epilepsie, aux antiepileptiques et/ou aux reactions du partenaire.

Only 1% to 5% of HIV patients who develop a direct complications following. HIV infection can result in stroke via several mechanisms, including opportunistic infection, vasculopathy, cardioembolism, and coagulopathy. It is a rare association, here we report the case of a woman of 69 years immunocompromised who Stroke diagnosed without another etiology found despite an etiologic assessment of the most common causes in our context. The patient had received treatment with an overall favorable evolution. Before a stroke recurrent of unknown etiology should think of HIV as this will allow appropriate treatment. The mechanism can be related with syphilis (Vasculitis) or by direct action of the virus on the central nervous system.

The migraine is a chronic neurological disease that affects 10 to 12% of the population, with a clear preponderance females and this from puberty. The women report a longer attack duration. Presence and severity of associated symptoms, such as photophobia, phonophobia, nausea, vomiting, and cutaneous allodynia are more prevalent in women. Some clinical forms are well described as catamenial migraine. Several comorbidities have been described in migraine women. Among these diseases associated with migraine: vascular diseases, asthma, allergies, epilepsy, restless legs syndrome, and various chronic pain syndromes and psychiatric disorders. Treatment of migraine in women raises the difficulty of managing seizures and during pregnancy and the period of menstruation. The therapeutic difference mainly concerns menstrual migraine. In women with migraine, it is therefore recommended to be particularly attentive to comorbidities, the presence of which significantly increases the risk of arterial vascular events. Migraine is very common with a particular impact on the quality of life of women. These various specificities and their evolution over time must lead to continuous training of general practitioners, other specialists in women's health including gynecologists in order to reduce the morbidity of the disease by better prevention of crises through the harmonization of research by scientific societies from different continents.

Introduction L’AVC constitue un veritable probleme de sante publique. Il represente la premiere cause d’hospitalisation et de mortalite a la clinique neurologique du CHNU de Fann a Dakar. Objectifs Evaluer les connaissances de l’AVC aupres des accompagnants des patients victimes d’AVC en vue d’ameliorer la sensibilisation sur cette affection et de rendre effective la thrombolyse a Dakar. Methodes Il s’agit d’une etude prospective et operationnelle, de decembre 2015 a mai 2017 a la clinique neurologique du CHNU de Fann. Resultats L’âge des participants variait de 17 ans a 98 ans. Les facteurs de risque cites etaient la sedentarite (84 %), le regime riche en cholesterol (82 %), le stress (80,33), l’hypertension arterielle (79 %), l’obesite abdominale (74 %). Le deficit moteur etait identifie par 210 participants (70 %). Au total, 277 participants (92,33 %) repondaient qu’il fallait conduire le malade a l’hopital precocement. Seuls 21 sujets (7 %) avaient cite des anti-hypertenseurs, 17 sujets, (5,66 %) la reeducation fonctionnelle. Un participant (0,33 %) avait cite la thrombolyse. Discussion De cette etude, nous pouvons deduire que les frequentes campagnes de sensibilisation sur l’AVC ont permis a la population senegalaise d’en acquerir des connaissances globales. Cependant, il sera necessaire ulterieurement d’insister sur les differents moyens therapeutiques disponibles. Conclusion Les connaissances sur l’AVC constituent un des moyens pour prevenir ce probleme de sante publique. Informations complementaires Financement : aucun.

Introduction: Synthetic anti malaria drugs has effectiveness in the treatment of many auto-immune diseases and principally the systemic erythematous lupus. The undesirable effects remain rare. The appearance of myopathy is considered as exceptional. We report observations which highlight the hypothesis of a double toxicity (Chloroquine and Hydroquinine). Observation: We report a case of 53 years old female patient treated chronically by Hydroquinidine and Escitalopram for Bouveret diseases which became asymptomatic. Later on, we had Chloroquine and Prednisone to the previous treatment. Prednisone was removed few months later because of a possible skin side effect. Due to the incomplete relief of joint pain we had Methotrexate to the treatment associated to Omeprazole. And the evolution was characterized by the appearance of lower limbs muscle weakness leading to the interruption of Methotrexate- Omeprazole association. Despite this interruption there was a worsening of the muscle weakness clinically and electro-physiologically diagnosed as myopathy which leads to the interruption of Chloroquine and Hydroquinidine. Other causes of myopathy have been ruled out after a large check-up and Methotrexate was re-introduced two months later with progressive regression of symptoms within six months. Discussion and conclusion: The appearance of myopathy in a patient treated by Chloroquine is extremely rare. Our observation highlights the toxicity of synthetic antimalarial drugs which can cause myopathy in some cases. The association of Chloroquine and Hydroquinidine seems potentially more toxic on muscles.

Considered for a long time as pathology of the elderly, stroke is more and more frequent in the young subject, 12 to 15% of the stroke occurs in the people under 50 years old. The situation is alarming because the consequences are tragic on the economic and social levels. We will be interested in the stroke of the young women. This is a cross-sectional descriptive study over 22 month in neurology department in Fann teaching hospital, period from August 2012 to June 2014. This allowed to the compilation of 109 patients with stroke according to the WHO definition and aged between 16 and 50 years. This study focuses on 109 women aged between 17 and 50 years with an average age of 39.95 years. The most representative age range is between 36 and 45 years. Only 3.7% of patients had a level of education higher than baccalaureate, 59.6% were not in school.57.8% had an ischemic stroke and 42.2% had a hemorrhagic stroke, with an average age of 39 years for ischemic stroke and 40 years for hemorrhagic stroke. The most important cardiovascular risk factors for ischemic stroke were dyslipidemia (73%), high blood pressure (42.9%), sedentary lifestyle (38.1%), and estrogen-progestin contraception intake were found in 23.8 % of cases. According to the TOAST classification, the etiology is embolic heart disease (25.4%), macroangiopathy (17.5%), microangiopathy (7.9%), others (15.9%), and in 41.2% of the patients the etiology is not found. The main cardiovascular risk factors in hemorrhagic stroke were hypertension (80.4%), dyslipidemia (58.7%), sedentarily (59.1%), migraine (23.9%) an oestroprogestative contraception intake (6.5%).The etiologies of hemorrhagic stroke are arterial hypertension (80.4%), left middle cerebral artery aneurysm (6.5%), arteriovenous malformation (4.3%), infectious arteritis (4.3%), hemostasis disorder (2.2%), and undetermined origin (2.2%). Bad eating habits, sedentary lifestyle lead an increase cardiovascular risk factors and, at the same time, the stroke rate in young women. Prevention must go through a good awareness-raising policy.

Introduction Probleme de sante publique mondiale, l’epilepsie est une pathologie chronique necessitant un traitement medicamenteux au long cours, susceptible de reactions adverses et/ou perturbations biologico-metaboliques. Objectifs Ce travail permettait de verifier les variations des parametres lipidiques pouvant survenir au cours du traitement antiepileptique (TAE), et d’etudier l’influence du polymorphisme de l’haptoglobine (Hp) sur l’evolution de l’epilepsie. Patients et methodes Etude longitudinale prospective d’octobre 2012 a decembre 2013 avec recrutement en service de neurologie d’epileptiques, suivis depuis au moins 2 ans, sous traitement adapte, bien suivi, a dose efficace, sans prejuger du type d’epilepsie. Ces patients furent apparies avec des temoins sains, similaires en âge et sexe. Des prelevements sanguins furent realises au repos, a jeun. Analyse sur logiciel Statview : test Mann–Whitney pour comparer les variables entre patients et temoins ( p Resultats Trente-huit patients et 38 temoins : 53 % de femmes et predominance des 20–39 ans. L’epilepsie evoluait depuis 2–30 ans, traitees par monotherapie (52,6 %), majoritairement phenobarbital (71 %) et Carbamazepine (44,73 %) depuis 2–28 ans. Pas de difference entre patients et temoins pour la glycemie et le HDL cholesterol, mais elevation significative chez les epileptiques du cholesterol total, LDL, triglycerides, de l’uree et creatininemie. Frequence des crises significativement plus importante avec profil Hp2.2. Discussion L’augmentation significative des parametres lipidiques et renaux chez les epileptiques au cours du traitement suggererait une exposition aux complications cardiovasculaires. Ce phenomene pourrait etre medie par l’haptoglobine 2.2 plus frequent chez nos epileptiques et sources de crises plus importantes. Mais aussi par l’augmentation sanguine d’homocysteine associee a une baisse de l’acide folique, retrouves sous TAE prolonge. Conclusion Les differences de susceptibilite chez des epileptiques de phenotypes variables pourraient etre liees au polymorphisme fonctionnel de genes codant pour des enzymes/proteines dont l’haptoglobine : porte ouverte aux complications cardiovasculaires ? Informations complementaires Remerciement au Pr Pape Madieye Gueye pour l’initiative de l’etude et a Mme Marieme Sall pour en etre la cheville ouvriere.

Introduction Les Accidents Vasculaires Cerebraux Hemorragiques (AVCH) representent 10 a 15 % de l’ensemble des AVC. Ils sont responsables d’une mortalite lourde. Objectifs L’objectif de ce travail etait de determiner l’epidemiologie de l’AVCH chez les patients hospitalises a la clinique neurologique du CHU de Fann (Dakar). Patients et methodes Nous avons realise une etude retrospective entre le 1er janvier 2013 et le 31 decembre 2014 portant sur des dossiers de patients admis pour AVCH. Resultats sur 495 patients admis pour AVC, 171 etaient hemorragiques soit une proportion de 34,5 %. L’âge moyen etait de 57 ans avec une predominance masculine. Les patients venant de la banlieue de Dakar etaient de 60,23 % (103 cas). Les facteurs de risque d’AVC etaient domines par l’HTA (57,3 %) l’antecedent d’AVC (14,2 %). La mortalite hospitaliere etait de 42,1 %. A une semaine 66,6 % des patients etaient decedes soit plus de la moitie de la population decedee. Discussion Les AVCH representaient le tiers des AVC. Ce constat a ete observe dans des etudes anterieures en Afrique. Le delai tardif de prise en charge et l’inexistence d’unites neuro vasculaires expliquerait la lourde mortalite. La presence d’unite neuro vasculaire reduirait la mortalite. Conclusion L’AVCH demeure un defi de sante publique, il convient de mettre en place des programmes nationaux de prevention des facteurs de risque cardiovasculaire.

Dementia is a serious disease due to its morbidity and mortality. The etiology is dominated by Alzheimer's disease. However, there are dementia syndromes related to treatable and potentially curable cause. It’s rarely reported in clinical practice in our context. We report a case of dementia associated with lymphoblastic acute leukemia complicated by lymphocytic meningitis. F. ND aged 66, widow, unschooled and unemployed was hospitalized for gait disturbance and progressive appearance of memory disorders. On physical examination, there was a dementia syndrome, bilateral pyramidal syndrome. The rest of the clinical examination associated with additional tests (thoraco-abdominal-pelvic CT scan, lumbar puncture, and myelogram) was in favor of lymphocytic meningitis and acute lymphocytic leukemia. Dementia is a disease in which the search for the cause is crucial for considering an etiological support. Blood diseases such as LAL are treatable causes. The clinic provides a guidance element of research. Also, multidisciplinary care is necessary in these kinds of patients for a better development. This scientific cooperation must be done with, hematologists, internal medicine specialists and other colleagues.

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.

Introduction L’accident vasculaire cerebral ischemique ou hemorragique touche de plus en plus les sujets tres jeunes. Objectifs L’objectif de cette etude est d’apprecier ces facteurs etiologiques chez les enfants. Patients et methodes Il s’agit d’une etude retrospective descriptive allant de juillet 2009 a juillet 2015 a la clinique neurologique du CHU de Fann et a l’hopital d’enfant Albert Royer de Dakar. Elle concernait les enfants âges de 1 mois a 18 ans presentant un accident vasculaire cerebral ischemique confirme par l’imagerie cerebral (scanner). Resultats Nous avons collige 65 patients, l’âge moyen etait de 7,05 ans : – pathologie de l’hemoglobine : 72,30 ; – multiples possibles etiologies : 12,32 % ; – cardiopathie emboligene : 7,69 % ; – etiologie indeterminee : 4,62 % ; – meningo-encephalite a VIH : 3,06 %. Discussion A l’inverse des sujets âges ou l’arteriosclerose domine le tableau ; chez l’enfant les atteintes de l’hemoglobine etaient les plus frequentes. Conclusion Le depistage et traitement des anomalies de l’hemoglobine chez l’enfant semblent etre necessaire pour la prevention de pathologie comme l’accident vasculaire cerebral dont les sequelles sont lourdes.