4 research outputs found
Headaches in consultation in the workplace in Ouagadougou (Burkina Faso): impact on the quality of life and the patientâs professional performance
Objective: Headaches are a real public health problem. This study describes the impact of headaches on quality of life and job performance in a working population in Ouagadougou.Methods: This was a cross-sectional descriptive study from April to June 2011, conducted in six workplaces in the city of Ouagadougou and covering 110 workers. Workers with any headaches who consulted in health centers of workers during the study period were interested. The epidemiology, clinical aspect and impact of headaches were assessed using HIT-6 questionnaire and MIDAS test.Results: The prevalence of headaches was estimated at 8%. The average age was 38.5 years old. By correlating the total number of workers in society by gender and the number of patient who consulted for headaches, we found 8% of females against 7% for males. Seen the profile of different companies, headaches were found mainly among laborers (67.3%). Following the history and clinical examination of patients, the prevalence of primary headaches was 83.6% against 16.4% for secondary headaches. Headaches with most significant impact on daily life were observed respectively for 17.3% and 31.8% in the HIT-6 test. Grade III and IV of disability were recorded respectively for 21.8% and 9.1% in the MIDAS test. The correlation between the functional disability associated with headaches and the professional category found moderate and severe disability respectively for 54.1% and 70% of laborers while no senior executive had moderate or severe functional disability. The correlation between the impact of headaches on the activities of daily life and the professional category found substantial and severe impact respectively for 78.9% and 57.2% of laborers while 5.7% of senior executives had a severe impact. the correlation between functional disability related to headaches and the gender found 10,5% of severe disability for women and 8.8% for men. The correlation between the impact of headaches on daily life and the gender found 42.1 of severe impact for women and 29.7% for men.Conclusion: Headaches impose a heavy burden in the workplace especially for women and laborers. Their adequate care will improve the quality of life of workers with headaches for better work performance.Keywords: Headaches, Impact, Quality of Life, Performance, Workplace, Burkina Fas
Pertinence du neuromonitoring multimodal dans les lesions doubles : A propos de la prise en charge, a lâhopital neurologique de lyon, dâune scoliose congenitale avec deficit neurologique rapide
Nous rapportons un cas illustrant quâune Ă©valuation clinique, radiologique et neurophysiologique exhaustive est obligatoire avant une chirurgie de scoliose sĂ©vĂšre. Une patiente a Ă©tĂ© rĂ©fĂ©rĂ©e pour bĂ©nĂ©ficier dâune correction chirurgicale dâune scoliose congĂ©nitale malformative. Lâexamen clinique Ă lâadmission a rĂ©vĂ©lĂ© une tĂ©traparĂ©sie qui a imposĂ© un changement urgent de stratĂ©gie chirurgicale. Lâimagerie par rĂ©sonance magnĂ©tique a objectivĂ© un neurofibrome C2-C3. Les potentiels Ă©voquĂ©s somesthĂ©siques (PES) des membres supĂ©rieurs et infĂ©rieurs Ă©taient normaux mais les potentiels Ă©voquĂ©s moteurs (PEM) Ă©taient abolis. Leur rĂ©apparition peropĂ©ratoire lors de la rĂ©section du neurofibrome a prĂ©cĂ©dĂ© une amĂ©lioration clinique progressive. La rĂ©cupĂ©ration spectaculaire des PEM a permis une correction de la dĂ©formation de la colonne vertĂ©brale sous surveillance peropĂ©ratoire plusieurs mois plus tard.
French title: Relevance of multimodal neuromonitoring in dual lesions: About the management, in lyon neurological hospital, of congenital scoliosis with rapid neurological deficit
We report a case illustrating that exhaustive clinical, radiological and neurophysiological assessment is mandatory before severe scoliosis surgery. A patient was referred for surgical correction of congenital malformative scoliosis. Clinical examination admission revealed a tetraparesis that enforced an urgent change in surgical strategy. Magnetic Resonance Imaging disclosed a C2-C3 neurofibroma. Upper and lower limbs somatosensory evoked potentials were normal but motor evoked potentials (MEPs) were abolished. Their intra-operative reappearance at the time of neurofibroma resection preceded a progressive clinical improvement. The spectacular MEPs recovery allowed correction of the spinal deformity under intraoperative monitoring several months later
Encephalopathies epileptogenes precoces avec suppression burst
IntroductionLes EncĂ©phalopathies EpileptogĂšnes prĂ©coces avec « suppression burst » sont graves du fait de leur pharmacorĂ©sistance et lâimpact sur le dĂ©veloppement psychomoteur des enfants atteints. Notre objectif est dâen identifier les dĂ©terminants chez des patients Ă Dakar.MĂ©thodologieIl sâagissait dâune Ă©tude rĂ©trospective et prospective Ă partir de dossiers mĂ©dicaux allant de janvier 2013 Ă janvier 2015, rĂ©alisĂ©e Ă la clinique Neurologique du CHNU Fann et portant sur des enfants qui y sont suivis. Elle nâa intĂ©ressĂ© que les patients avec Ă©pilepsie prĂ©coce, retard du dĂ©veloppement psychomoteur et pattern de suppression burst Ă lâEEG. Les aspects anamnestiques, cliniques, Ă©lectro- encĂ©phalographiques et Ă©volutifs sous traitement ont Ă©tĂ© Ă©valuĂ©s.RĂ©sultatsNous rapportons quatre observations dâenfants avec une notion dâĂ©pilepsie familiale non documentĂ©e chez deux, qui ont prĂ©sentĂ© une encĂ©phalopathie prĂ©coce avec des crises Ă©pileptiques polymorphes dominĂ©es par des crises toniques. Celles-ci ont dĂ©butĂ© le premier jour de vie chez deux enfants, Ă 30 jours de vie et en dĂ©but du troisiĂšme mois de vie chez les deux autres. LâEEG de sommeil rĂ©alisĂ© au moment du diagnostic a montrĂ© un pattern de suppression burst. Aucune étiologie nâa Ă©tĂ© retenue du fait de la  limitation du bilan complĂ©mentaire Ă visĂ©e Ă©tiologique tel que lâIRM cĂ©rĂ©brale ou les bilans mĂ©taboliques. LâĂ©volution Ă©lectro-clinique est favorable pour certains patients avec le traitement entrepris, basĂ© principalement sur le valproate de sodium Ă une dose de 20mg/Kg/jr en moyenne. Elle est marquĂ©e par la disparition des crises ou leur diminution en frĂ©quence et par lâamĂ©lioration du tracĂ© EEG de sommeil de contrĂŽle avec disparition des bouffĂ©es suppressives chez trois patients, tandis que chez le quatriĂšme, lâĂ©volution sâest faite vers un autre type dâencĂ©phalopathie Ă©pileptogĂšne quâest le syndrome de West. Le retard psychomoteur est restĂ© patent chez la totalitĂ© des patients.ConclusionLes rĂ©sultats de ce travail ouvrent la perspective Ă des Ă©tudes complĂ©mentaires notamment  longitudinales qui permettraient de mieux individualiser ces pathologies graves Ă dĂ©but prĂ©coce dâautant plus quâil existe des causes curables. IntroductionEarly epileptic encephalopathies with "suppression burst" are serious because of their drug resistance and the impact on psychomotor development of children involved. Our objective is to identify the determinants of this pathology in Dakar.MethodologyThis is a retrospective and prospective study from medical records from January 2013 to January 2015, performed on children who followed at the Neurological clinic of Fann University Hospital of Dakar. It has interested patients with early epilepsy, delayed psychomotor development and EEG pattern of suppression burst. Anamnestic, clinical, electroencephalographic and progressive aspects under treatment were evaluated.ResultsWe report four cases of children with epilepsy notion of family in two undocumented, who presented early encephalopathy with seizures polymorphic dominated by tonic seizures that began on the first day of life in two, 30 days of life and the beginning of the third month of life in the other two. The sleep EEG performed at diagnosis showed a pattern of suppression burst. No etiology was chosen because of the limitation of additional balance sheet etiological such as MRI cerebral or metabolic balance sheets. The electro-clinical evolution is favorable for some patients with the treatment undertaken, based mainly on sodium valproate at a dose of 20mg/Kg/day in average. It is marked by the disappearance of seizures or decreased in frequency and by improving the sleep EEG control monitoring with disappearance of suppression burst in three patients, while in the fourth, the change was made to another type of epileptic encephalopathy that is the West syndrome. Psychomotor retardation remained evident in all patients.ConclusionThe results of this work open up the prospect for further studies including longitudinal that would better individualize these serious early diseases especially because it exists treatable causes
Apport des explorations radiologiques et neurophysiologiques dans le bilan des nevralgies cervico-brachiales observees dans un laboratoire de neurophysiologie clinique a Dakar Au Senegal
Introduction: Lâimagerie occupe une place de choix dans le bilan dâune NĂ©vralgie Cervico-Brachiale (NCB). Dâautres explorations paracliniques peuvent aider et dans notre laboratoire, lâElectro-Neuro-Myographie (ENMG) et les Potentiels EvoquĂ©s SomesthĂ©siques (PES) sont couramment rĂ©alisĂ©s dans le cadre du bilan des NCB. Dans cette Ă©tude, nous avons voulu montrer lâapport des examens radiologiques et neurophysiologiques dans le diagnostic de NCB.MĂ©thodes: Il sâagit dâune Ă©tude rĂ©trospective sur une pĂ©riode dâun an, rĂ©alisĂ©e chez des patients reçus dans un laboratoire de neurophysiologie Ă Dakar pour une suspicion clinique de NCB et ayant eu une Radiographie standard et/ou une TDM et /ou une IRM du rachis cervical. Chez ces patients nous avons rĂ©alisĂ© un ENMG des membres supĂ©rieurs avec lâĂ©tude des paramĂštres suivants : latences des Ondes F, des Vitesses de Conduction Nerveuse et DĂ©tection Ă lâaiguille dans les muscles aux membres supĂ©rieurs. LâENMG a Ă©tĂ© couplĂ© aux Potentiels EvoquĂ©s SomesthĂ©siques (PES) des membres supĂ©rieurs obtenus par stimulation digitale des territoires radiculaires avec recueil des Ondes N9, N13 et N20.RĂ©sultats: 14 patients ont Ă©tĂ© inclus dans lâĂ©tude, 8 examens radiologiques sur 14 Ă©taient anormaux objectivant en majoritĂ© des lĂ©sions de cervico-uncarthrose Ă©tagĂ©e. LâENMG Ă©tait normal chez 13/14 patients, la seule anomalie Ă©tait une atteinte axonale tronculaire du nerf cubital chez un patient dont les PES Ă©taient en faveur dâun tableau de polyradiculopathies. Chez 1 patient seulement sur 14 tous les examens (imagerie, ENMG et PES) Ă©taient normaux. Les 13 autres patients prĂ©sentaient un allongement des latences des PES en faveur majoritairement dâune polyradiculopathie C6 et/ou C7 et/ou C8. Parmi ces 13 patients, 05 avaient une imagerie normale. Commentaires Lâimagerie et les explorations neurophysiologiques normales nâĂ©liminent pas une NCB. Lâapport de ces diffĂ©rents examens se situe au niveau du diagnostic positif, diffĂ©rentiel et Ă©tiologique des NCB Ă condition de les coupler.
English title: Contribution of radiological and neurophysiological exams in cervico brachial Neuralgia assessment seen in a laboratory of clinical neurophysiology in Dakar/Senegal
Introduction: Imaging plays a key role in Cervico-Brachial Neuralgia (CBN) assessment. Other paraclinical explorations may help and in our laboratory, Electro-Neuro-Myography (ENMG) and Somesthesic Evoked Potentials (SEPs) are commonly performed as part of the CBN assessment. In this study, we wanted to identify the contribution of each of the different radiological and neurophysiological exams in the diagnosis of CBN.Methods: This is a retrospective study over a one-year period, performed in patients received in one neurophysiological laboratory in Dakar for a clinical suspicion of CBN and who performed also cervical radiological exams: standard radiography and/or CTscan and/or MRI. For these patients, we performed an ENMG of the upper limbs with the study of latencies, amplitudes, Nerve conduction velocity, F waves latencies, followed by Detection of muscles of the upper limbs. We coupled ENMG with the study of SEPs of the upper limbs by fingerâs stimulation of root territories with recorded of N9, N13 and N20 waves.Results: 14 patients were included in the study, 8/14 radiological exams were abnormal and most of the cases show lesions of cervical arthrosis. ENMG was normal for 13/14 patients, the only abnormality was an axonopathy of the ulnar nerve for a patient whose SEPs were in favor of polyradiculopathies. For only 1/14 patients, all exams (imaging, ENMG and SEPs) were normal. The others 13 patients had long latencies SEPs in favor of C6 and/or C7 and/or C8 polyradiculopathies. For these 13 patients, 05 had normal imaging.Comments: Normal imaging and neurophysiological exams do not rule out a CBN. The contribution of these different exams is for positive, differential and etiological diagnosis. It seems important to link all these exams to optimize the CBN diagnosis