Thrombophlebite cerebrale et drepanocytose SC : A propos d’un cas et revue de la litterature

Les auteurs rapportent un cas de thrombose veineuse cérébrale chez une patiente de trente-sept ans drépanocytaire SC, qui a présenté un état confusionnel au décours d’une hospitalisation pour fracture non déplacée de la jambe droite. L’exploration de la patiente par scanner cérébral et par l’angioIRM cérébrale a révélé une thrombose du sinus sagittal supérieur Les examens biologiques n’ont pas révélé aucun autre état  hypercoagulable héréditaire ou acquis. L’évolution a été favorable sous anticoagulation efficace par héparine de bas poids moléculaire avec relais per os par rivaroxaban L’intérêt de ce dossier réside dans la rareté de cette observation en Afrique Noire, où pourtant sévit la drépanocytose. English Title: Cerebral venous thrombosis and sickle cell disease SC: Case report and literature reviewThe authors report a case of cerebral venous thrombosis in a thirty-seven-year-old sickle cell SC patient, who presented with a confusional state during hospitalization for a non-displaced fracture of the right leg. Exploration of the patient by cerebral CT and MRI brain angiography showed superior sagittal sinus thrombosis. Biological examinations did not reveal any other hereditary or acquired hypercoagulable condition. The evolution was favorable after effective anticoagulation by low molecular weight heparin with per os relay by rivaroxaban The interest of this file resides in the scarcity of this observation in Black Africa, where, however, sickle cell disease occur

Cephalees primaires et qualite de vie de l’etudiant en medecine de l’Universite de Kara (Togo)

Introduction: Les céphalées constituent un problème de santé publique et une plainte fréquente aussi bien en milieu professionnel, scolaire qu‘estudiantin.Objectif: Déterminer le profil épidémiologique et clinique des céphalées primaires de même que leur impact sur la  qualité de vie des étudiants de médecine de l‘Université de Kara.Patients et Méthode: Il s‘est agi d‘une étude descriptive et transversale du 27 au 29 novembre 2018 qui a porté sur les étudiants de médecine de la Faculté des Sciences de la Santé de l‘Université de Kara.Résultats:La prévalence des céphalées était de 75,27% et l‘âge moyen des étudiants concernés était de 21,07 +/- 1,77 ans. Cette prévalence s‘élevait avec le niveau d‘étude allant de 60% en deuxième année jusqu‘à 86,67% en quatrième année (Chi-2 = 6,0705 ; p ≤ 0,0481). Selon le sexe, 85% des femmes contre 72,26% des hommes en souffraient. La prévalence de la migraine était de 36,56% et celle des céphalées de tension (CT) était de 21,50%. Quarante-sept pour cent des migraineux et 25% de ceux avec CT avaient très souvent un trouble de la concentration. La durée moyenne d‘absence due aux céphalées primaires au cours des trois derniers mois était de 4,97 jours.Conclusion: L‘impact négatif des céphalées sur la qualité de vie des étudiants nécessite une consultation spécialisée.   English title: Primary headaches and quality of life in medical students at Kara University (Togo) Background: Headache is a public health problem and a common complaint in both professional and academic settings. Aim: To determine the epidemiological and clinical profile of primary headaches and their impact on the quality of life of medical students at Kara University. Patients and Method: This was a descriptive and cross-sectional study from 27 to 29 November 2018 that focused on medical students from the Faculty of Health Sciences, University of Kara. Results: The prevalence of headache was 75.27% and the average age of the students concerned was 21.07 +/- 1.77 years. This prevalence rose with the level of study ranging from 60% in second year to 86.67% in fourth year (Chi-2 = 6.0705, p ≤ 0.0481). By sex, 85% of girls and 72.26% of boys were suffering. The prevalence of migraine was 36.56% and that of tension-type headaches (TTH) was 21.50%. Forty-seven percent of students with migraine and 25% of those with TTH very often had a concentration disorder. The mean duration of absence due to primary headaches in the last three months was 4.97 days. Conclusion: The negative impact of primary headaches on the quality of life of medical students requires specialized consultation

Encephalite limbique paraneoplasique, un syndrome mal connu : A propos d’un cas a Lome (Togo)

Introduction : Les encéphalites limbiques pures sont des complications rares des cancers. Elles affectent aussi bien les hommes que les femmes. La tumeur associée est le plus souvent un cancer du poumon à petites cellules.Cas clinique : Nous rapportons le cas d‘un patient de 78 ans, tabagique actif, hospitalisé pour un trouble de comportement à type d‘agressivité verbale avec propos incohérents dans un contexte d‘amaigrissement et d‘asthénie d‘aggravation progressive. L‘examen clinique retrouvait une amnésie antérograde avec des fabulations associées à une adénopathie sus claviculaire droite. Les explorations paracliniques ont permis de retrouver un carcinome pulmonaire avec à l‘IRM encéphalique, un hypersignal T2 dans la région  hippocampique gauche permettant de poser le diagnostic d‘encéphalite limbique paranéoplasique. L‘évolution sous chimiothérapie et radiothérapie a été favorable.Conclusion : L‘encéphalite limbique paranéoplasique constitue une entité rare et mérite d‘être suspectée au même titre que les autres causes d‘encéphalopathies. English title: Paraneoplastic limbic encephalitis, a badly known syndrome: A case report in Lomé (Togo) Background: Pure limbic encephalitides are unusual complications of cancers. Both men and women can be affected. The associated tumor is most often a small cell lung cancer.Case report: We reported the case of a 78-year-old patient who was an active tobacco addict. He was hospitalized for a behavioral disorder  like verbal aggression with incoherent speech in a context of progressive weight loss and asthenia. Clinical examination revealed anterograde amnesia with confabulations associated with right supraclavicular lymphadenopathy. Paraclinical explorations revealed a pulmonary carcinoma with at MRI, a T2 hypersignal in the left hippocampal region.Therefore, the diagnosis of paraneoplastic limbic encephalitis has been made. The evolution with chemotherapy and radiotherapy was favorable.Conclusion: Limbic paraleoplastic encephalitis is a rare clinical entity and should be rouled out during a work-up for every case of encephalitis

SLA et VIH : Cas d’une patiente seropositive au VIH-1 et revue de la litterature

La Sclérose Latérale Amyotrophique est une pathologie neuro dégénérative rare. Son association avec le VIH l‘est encore plus. Dans le but de déterminer l‘implication du VIH dans la survenue de la SLA, nous rapportons le cas d‘une patiente de 51 ans, séropositive au VIH-1 qui a présenté une SLA à début spinal et qui est décédée après 30 mois d‘évolution malgré la prise en charge spécifique de la SLA et du VIH. Cette observation laisse persister une interrogation. Existerait-il un sous-type de VIH responsable du déclenchement de la SLA ? English title: ALS and HIV: A HIV-1 seropositive patient and literature review Amyotrophic Lateral Sclerosis is a rare neurodegenerative disease. Its association with HIV is even more so. In order to determine the involvement of HIV in the occurrence of ALS, we report the case of a 51-year-old female HIV-1 positive with spinal-onset ALS who died after 30 months despite the specific management of ALS and HIV. This observation leaves a question mark. Is there a subtype of HIV responsible for triggering ALS

Wallenberg Syndrome secondary to bilateral vertebral artery dissection and thrombosis

The Wallenberg syndrome or lateral medullar syndrome (LMS) is also known as posterior inferior cerebellar artery syndrome. It‘s a  dangerous affection because of his gravity for vital prognostic by the paralysis of cranial nerves. Occlusion of these vessels may be due to stenosis from arteriosclerosis/emboli or arterial dissection. The artery dissection may be spontaneous or after trauma is an important and often treatable cause of the stroke in younger people. The Magnetic Resonance Imagine diffusion weighted inversion (MRI-DWI), the  Magnetic Resonance Angiography (MRA) sequence FAT/SAT and the computed tomography (CT) angiography of the brain allow quickly to the diagnosis. The antithrombotic treatment (antiplatelet drug) and low-molecular weight heparins allow to reduce the neurological  sequelea. So we report two cases of Wallenberg‘s syndrome caused by spontaneous bilateral vertebral dissection and vertebral thrombosis and their clinical, prognostic and therapeutic aspects. A 34-years-old woman, no cardiopathy factors only obesity, no trauma, admitted for acute vomiting, vertigo, neck pain and weakness earlier in themorning and MRA FAT/SAT showedbilateral vertebral artery dissections without an evident posterolateral medulla infarct on MRI-DWI. A 48-year-old man, cumulated cardiopathy factors risks,  admitted with sudden vertigo, disequilibrium and neck pain. The MRI-DWI showed an acute left posterolateral medulla infarct and the CT angiography revealed thesevere left vertebral artery thrombosis. They were treated by the antithrombotic drugs (antiplatelet drugs) and low-molecular weight heparins. In front of a sudden neck pain and vertigo, think about Wallenberg‘s syndrome and do quickly an imaging. French title: Syndrome de Wallenberg secondaire a une thrombose et une dissection vertebrale bilateral

Prévalence De La Douleur Neuropathique Chez Des Patients Souffrant De Lomboradiculalgie Commune En Consultation Rhumatologique À Lomé (Togo)

Objective: To determine the prevalence and factors associated with neuropathic pain in patients with non-specific low back pain. Methods: This was a cross-sectional study conducted from May to July 2016 in the Rheumatology, Neurology and Neurosurgery departments of Lome. The DN4 questionnaire was used for the diagnosis of neuropathic pain in the 200 patients with low back pain included in this study. Results: Of the 200 patients (147 women and 53 men) included in the study, neuropathic pain was present in 92 (46%). The average age of the 92 patients (67 women vs 25 men, p = 0.04) was 55.5 ± 12.4 years (women 55.2 ± 12.8 vs. men 54.6 ± 11.4, p = 0.5). The characteristics of neuropathic pain mainly found were: burning sensation (n = 67, 72.8%); electrical discharges (n = 64, 69.6%); tingling (n = 90; 97.8%); tickling (n = 57; 62%); numbness (n = 89; 96.7%); hypoesthesia (n = 52; 56.5%). Factors significantly associated with the presence of neuropathic pain in LBP were age (p = 0.005), duration of LBP (p = 0.04), high blood pressure (p = 0.001), radicular pain (p = 0.00002) and the past history of the LBP (0.000000). Conclusion: Neuropathic pain is common in patients with LBP at Lome. The duration of LBP, past history of LBP, previous NSAID use, BMI, pain severity and radicular pain appear to be predictive of the occurrence of these neuropathic pains

HIV Status and Psychosexual Problems among Young Adults in Togo

This research verified the link between HIV status and sexual problems in young adults. Based on the results of our study following the administration of the self-assessment questionnaire on sexual problems (male and female), we came to the conclusion that HIV-positive status causes more sexual problems, particularly among young men. Despite the problems of vaginal dryness and painful coitus observed in HIV-positive young women, we can say that HIV-positive young women do not generally have sexual problems that interfere with sexual activity

Maladie de forestier chez un jeune adolescent au CHU Campus de Lomé, Togo

Forestier’s disease is a non inflammatory esthesopathy that ossifying the anterolateral spine and sparing the disc and joint space in adults men. We report an early onset Forestier’s disease in a Togolese 20- year–old schoolboy. He was complained about proprioceptive ataxia, lower hearing and sight, and speech disturbance that began four years ago. X-ray showed an anterior weaving hyperostosis in spine, and multiple new growth of bones founded in skull, kneels and mandibles. Somatic and biological exam was normal.Keywords: Forestier’s disease, skeletal hyperostosis, ataxia, TogoJ. Rech. Sci. Univ. Lomé (Togo), 2012, Série D, 14(2) : 59-6