Polyradiculoneuropathy following infection with varicella zoster virus (VZV) is rare and most of the time, happens in the context of reactivation of latent VZV. We report a case of acute ...polyradiculoneuropathy following primary infection with VZV marked by atypical clinical features raising the hypothesis of a para-infectious disease.
We describe a 43-years-old male who developed ataxia, dysphagia, dysphonia, and oculomotor disorders (vertical binocular diplopia and bilateral ptosis) followed by quadriplegia with areflexia which occurred 4 days later. The patient had a history of varicella that occurred 10 days before the onset of these symptoms. Nerve conduction study revealed features consistent with an acute motor-sensory axonal neuropathy (AMSAN). Anti-ganglioside antibodies were negative. Based on clinical presentation and ancillary examination, we retain the Miller Fisher/Guillain-Barré overlap syndrome diagnosis. The patient was treated with high doses of methylprednisolone but the evolution of the disease was nevertheless marked by a complete recovery six weeks after onset of symptoms.
GBS following varicella is a rare but severe disease occurring most often in adults and marked by greater involvement of the cranial nerves. Its clinical features suggest that it is a para-infectious disease. Antiviral therapy has no effect on the course of the disease but its administration within the first 24 h after the onset of chickenpox in adults can prevent its occurrence.
Objective. To determine the prevalence of ischemic stroke deaths and their predictive factors in the Emergency Department at Yalgado Ouedraogo University Teaching Hospital (YOUTH). Methodology. This ...was a retrospective study with an analytical and descriptive focus over a period of three years from January 1, 2015, to December 31, 2017. Results. During the study period, 302 acute ischemic stroke patients with a mean age of 62.2±14.26 years were included. Atrial hypertension was the most common vascular risk factor in 52.5%. On admission, 34.8% of patients had loss of consciousness. The mean time to perform brain CT was 1.5 days. The average length of stay was 4 days. Electrocardiogram, echocardiography, and cervical Doppler were not performed during hospitalization in ED. The mortality rate was 39%, respectively, 37.6% in male and 41.6% in female. The mean age of patients who died in ED was 63.6±13.52 years. Hypertension was the most common vascular risk factors in 54.2% of death. After logistic regression, the predictors of death were past history of heart disease, consciousness disorders, hyperthermia, hyperglycemia on admission, poststroke pneumonia, and urinary tract infection. Conclusions. Acute ischemic stroke was frequent in Emergency Department with high mortality rate. The mortality risk factors were the same than those found in literature. This higher mortality can be avoided by early diagnosis and an adequate management.
Background
The community pharmacists educate patients and their families concerning the development of adherence to their therapy, and then improving health-related quality of life for those ...patients. Our study aims to describe the management of epilepsy in pharmaceutical pharmacies in a low income country.
Methods
This was a cross-sectional study carried out in the pharmaceutical pharmacies of the city of Ouagadougou during a period of 2 months, from November 15 to December 15, 2020.
Results
Fifty six pharmacists with a mean age of 41 ± 12.73 years were included in the study. Of them, 7.14% received specific training on epilepsy. Respondents with good knowledge about epilepsy were 48.21%. The level of “good knowledge” was significantly higher among respondents who had received specific training in epilepsy and among those with more than 15 years of experience as a dispensary pharmacist. The experience of more than 15 years was the factor significantly associated with a level of good knowledge about epilepsy. Regarding the seizure first aid management, the majority of pharmacists knew the attitudes of seizure first aid management by citing the lateral security position (83.9%). Phenobarbital was the most widely used antiepileptic drug in 96.43%. In 47.17% (
n
= 53) of pharmacies, demand exceeded supply.
Conclusions
Effort must be put on the supply of antiepileptic drugs and the training of health personnel.
Snake bites remain a major medical problem in West Africa, and hemorrhagic stroke following a snakebite has emerged as a rare secondary condition. The objective of this study was to determine the ...neurological complications following snake bite.
This study included all the cases of hemorrhagic stroke following snake bite admitted in the neurology Department of Yalgado Ouedraogo University Teaching Hospital during the period from January 1st, 2018 to December 31st 2019.
Three cases of hemorrhagic stroke following snake bite were included in the study. The strokes occurred 4-15 days after the snakebite. Traditional treatment was applied in two cases. Complications were significant, including local manifestations and severe anemia in 2 patients who received blood transfusion. Snake anti-venom was applied. At admission, motor deficit, conscience disorders and fever were the most frequent complaints. Patients received repeated dose of snake anti-venom was applied, antitetanus prophylaxis and antibiotherapy during hospitalization. The majority of the patients had completely recovered.
Hemorrhagic stroke following snake bites are rare in Burkina Faso. Clinical outcome of stroke was favorable after treatment by antivenom, anti-tetanus serum and antibiotics.
To determine the prevalence, clinical profile, causes, and mortality risk factors of spontaneous arachnoid haemorrhage at Yalgado Ouedraogo University teaching Hospital, we conducted a 5-year ...retrospective study of 1803 stroke patients admitted to Neurology Department during the period from January 2012 to December 2016. During the study period, spontaneous subarachnoid haemorrhage accounted for 3.2 % of all stroke. The mean age of patients was 60 years (range 20-93 years). There was a female predominance in 55.9%. The common vascular risk factors were hypertension (79.7%) and chronic alcohol consumption (16.9%). The main symptoms were headache (76.2%), motor weakness (74.5%), and consciousness disorders (62.7%). Neurological examination revealed limb weakness in 76.2% and meningeal irritation in 47.4%. The best admission Glasgow Coma Scale score of 15 was found only in 37.3 % of patients. About 50.8% of patients were admitted to Hunt and Hess moderate grade (III) resulting in a mortality of 24.80%. The main cause of spontaneous subarachnoid haemorrhage was hypertension (77.9%). Cause could not be determined in 8.5 % of cases. The mortality rate was 37.3%. There was high mortality in patients with intraventricular haemorrhage and in patients with disturbances of consciousness. In conclusion, our study showed a poor frequency of spontaneous subarachnoid haemorrhage with high mortality. Hypertension was the most common cause of spontaneous subarachnoid haemorrhage.
La neurocysticercose est une parasitose, cosmopolite. Elle constitue un problème de santé publique. Elle parait peu fréquente à Ouahigouya mais un dépistage plus systématique pourrait augmenter cette ...fréquence.
L’objectif de notre étude est de décrire les aspects cliniques, à l’imagerie et évolutifs de la neurocysticercose cérébrale à partir de cas hospitalisés au Centre Hospitalier Universitaire Régional de Ouahigouya.
Il s’agit d’une étude prospective des cas de neurocysticercose dans le service de neurologie du Centre Hospitalier Universitaire Régional de Ouahigouya entre le 1er juin 2017 et le 31 mars 2022.
Au total, 24 cas de neurocysticercose cérébrale ont été colligés au Centre Hospitalier Universitaire Régional de Ouahigouya. La fréquence globale est de 4,8 cas/an. L’âge moyen variait de 42 ans. 18 malades de sexe masculin et 6 féminins. 15 patients présentaient des lésions kystiques. Au total, 12 patients ont bénéficié d’une ponction lombaire. Tous les patients ont été traités avec de l’albendazole.
Il ressort de cette étude que la neurocysticercose paraît fréquente à Ouahigouya. Ce taux semble lié à la consommation de la viande de porc ou de bœuf male cuite et une hygiène alimentaire précaire. Ainsi l’examen d’imagerie cérébrale systématique à tous les patients suivis pour épilepsie s’avère nécessaire.
La neurocysticercose cérébrale parait peu fréquente au Burkina Faso. Les aspects cliniques font ressortir la prédominance des crises convulsives. Les traitements sont accessibles.
Les accidents vasculaires cérébraux constituent un enjeu majeur de santé publique en Afrique particulièrement au Burkina Faso. Ils nécessitent une prise en charge adéquate des patients atteints.
...Décrire les aspects épidémiologiques, cliniques et paracliniques des accidents vasculaires cérébraux au CHRU de Ouahigouya/Burkina Faso.
Nous avons mené une étude prospective et descriptive dans le service de neurologie du centre hospitalier universitaire régional de Ouahigouya au Burkina Faso allant du 1er janvier 2020 au 31 juillet 2021.
La fréquence hospitalière des accidents vasculaires cérébraux était de 12,7 %. L’âge moyen était de 54,5 ans. Nous avons retrouvé 56,2 % hommes et 44,8 % femmes. Nous avons retrouvé comme facteurs de risques l’hypertension artérielle 57,7 %. Les antécédents étaient représentés par les cardiopathies 48 %. Le délai moyen d’admission aux urgences était de 8 jours. Soixante-quinze pour cent patients ont bénéficié de la tomodensitométrie cérébrale. L’évolution était létale dans 8,5 %.
Nous avons constaté que les accidents vasculaires cérébraux ne sont pas que l’apanage des sujets âgés. La méconnaissance des signes cliniques au début et l’éloignement des centres de santé sont source du retard de la prise en charge des patients. Quand la prise en charge est tardive, la létalité reste élevée.
Les accidents vasculaires cérébraux sont des pathologies fréquentes en Afrique Noire nécessitant une prévention et une prise en charge adéquate.
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