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Neonatal Seizures: Frequency, Clinical Forms, Aetiology and Outcome in Tropical Practice
Bahoura Balaka,
Komi Assogba,
Fidato A. Touglo,
Damelan Kombaté,
Kossivi M. Apetsè,
Marie C. Ayassou-Madji
Issue:
Volume 3, Issue 5-1, October 2015
Pages:
1-4
Received:
19 May 2015
Accepted:
20 May 2015
Published:
17 June 2015
Abstract: Background: Seizures are common cause of paediatric admissions in poor resource countries and a risk factor for neurodevelopmental impairment. This study aimed to determine the frequency, clinical forms, aetiology and outcome of seizures in relation to rectal temperature in newborn. Patients and Methods: The study was located in paediatric department of our University Hospital. This prospective research had assessed consecutive admitted newborns aged 0-28 days with incident seizure during a period from January to December, 2013. Newborns with epilepsy and non-incident admission seizure were excluded. Results: Seizures were observed in 344/4836 (7.1%). The sample included 192 males and 152 females. The seizures frequency in newborn 0-21 days was 95.9% and was 52.6% in neonates < 1day. The focal seizures were reported in 68% follow by generalized tonic-clonic in 24.4%. Status epilepticus was observed in 7.6%. Seizures had occurred in a context of hypothermia in 77.9%, normal temperature, 14.2% and hyperthermia in 7.8%. The hypothermia and normal temperature seizures were more common in newborn < one week and hyperthermia was noted in older. The associated pathologies in the context of hyperthermia were neonatal infections (17.4%) and falciparum malaria (22.7%) respectively in one week newborn and older. Perinatal ischaemic/hypoxic (35.5%), falciparum malaria (13.6%) and respiratory tract infections and gastroenteritis (11.8%) were the main diseases associated with seizures in the context of hypothermia and normal temperature. The aetiologies were marked by neonatal brain injuries and perinatal asphyxia. Sixteen neonates with seizures were died giving a direct mortality rate of 4.7%. Eight (2.3%) surviving newborns had heavy neurodevelopmental deficits at discharge. Conclusion: The neonate seizures are an indicative of infection with or without fever. The causes of newborn convulsions must be prevented through a wide available public health programs.
Abstract: Background: Seizures are common cause of paediatric admissions in poor resource countries and a risk factor for neurodevelopmental impairment. This study aimed to determine the frequency, clinical forms, aetiology and outcome of seizures in relation to rectal temperature in newborn. Patients and Methods: The study was located in paediatric departme...
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Epidemiology and Clinical Description of Amyotrophic Lateral Sclerosis in Low Income Setting: A Syndrome with Short Survival
Komi Assogba,
Souleymane Brah,
Damelan Kombate,
Kossivi M. Apetse,
Rabi Barry-Barque,
Mofou Belo,
Koffi A. A. Balogou
Issue:
Volume 3, Issue 5-1, October 2015
Pages:
5-8
Received:
27 May 2015
Accepted:
28 May 2015
Published:
17 June 2015
Abstract: Background: Amyotrophic lateral sclerosis (ALS) is a degenerative motor neuron disease. It evolves to loss of autonomy and death. Objective: To describe the cases of ALS clinically definite observed in hospital field. Patients and methods: The retrospective study has covered a period of 10 years (2003-2012) and a total of 10,128 patient’s files were analyzed. The neurology department of our level 3 hospital has located the current study. Six patients with no particular medical history have been reported. The inclusion patients are cases where the diagnosis of ALS was clinically definite according to the modified El Escorial classification. About 978 of likely, possible and probable cases of ALS were not included. Results: The mean age was 49 years (24 and 67), all males, with a frequency of 0.59 ‰ and an incidence rate of 0.6 cases per year. The clinical signs were marked by the pyramidal syndrome and peripheral neuropathic motor syndrome. MRI or CT scan signs were marked by the bulbar light atrophy. EMG had shown spontaneous activities with reinnervation signs. The histology exam has found neurogenic fascicular atrophy. The average duration of progression of the disease from the diagnostic to death was 17.6 months (6 to 36). The median of survival all cases combined was 42 weeks. Symptomatic treatment was associated to rehabilitation. Riluzole has been established despite its high cost, but without success. Conclusion: This observation highlighted the major difficulties encountered in the management of ALS and its increasing frequency in south Saharan Africa.
Abstract: Background: Amyotrophic lateral sclerosis (ALS) is a degenerative motor neuron disease. It evolves to loss of autonomy and death. Objective: To describe the cases of ALS clinically definite observed in hospital field. Patients and methods: The retrospective study has covered a period of 10 years (2003-2012) and a total of 10,128 patient’s files wer...
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Arterial Territories Affected in the Thalamic Stroke: A Prospective Study Among Inpatients in Lome University Hospital, Togo
Komi Assogba,
Lantam Sonhaye,
Celikplim Akakpo,
Damelan Kombate,
Kossivi M. Apetse,
Mofou Belo,
Koffi A. A. Balogou
Issue:
Volume 3, Issue 5-1, October 2015
Pages:
9-13
Received:
31 May 2015
Accepted:
7 June 2015
Published:
17 June 2015
Abstract: Background and purpose: The thalamic infarct is frequent among ischemic stroke. We aim to determine the frequency of the thalamic infarct and analyze the different arterial territories affected in patients with thalamic syndrome. Patients and Methods: It was a prospective study. It focused on patients hospitalized in the neurology department of our university hospital, and covered the period from January to December, 2012. Only inpatients respondents to clinical and radiological criteria for diagnosis of thalamic ischemic stroke were included. All were evaluated with detailed clinical and neuropsychological evaluation, computer tomography scan (CT scan), routine blood studies, electrocardiogram, and transthoracic echocardiography. All standard risk factors were recorded in these patients. Results: A total of 768 files were analyzed of which 219 cases of cerebral infarction were selected. Among them, 12 patients had lesions involved only thalamic nuclei, which giving the frequency of 5.48%. The mean age was 59.33 years old with a ratio sex of 1.7. The clinical signs most observed were motor deficits (8/12), speech disturbances and anterograde memory impairment (7/12), and. sensory loss (5 cases). The high blood pressure was the main risk factor in all patients. The left thalamic ischemia was most frequent with 7/12 cases. The arterial territories affected were formed by the thalamotuberal arteries in 5/12, thalamoperforating arteries, (4/12), thalamogeniculate arteries, (3/12) and posterior choroidal arteries in 2/12, giving fourteen lesions. Conclusion: Thalamic infarct solely is not so rare and all its arterial branches may be affected. The sensory deficits and abnormal involuntary movement remain the embarrassing and difficult symptom to manage.
Abstract: Background and purpose: The thalamic infarct is frequent among ischemic stroke. We aim to determine the frequency of the thalamic infarct and analyze the different arterial territories affected in patients with thalamic syndrome. Patients and Methods: It was a prospective study. It focused on patients hospitalized in the neurology department of our...
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Current Data on the Profile of Patients Hospitalized for Stroke in a Neurology Department in West Africa: Abidjan (Ivory Coast)
Aka-Anghui Diarra Evelyne,
Zakaria Mamadou,
Mourtada Wardatou Dine,
Kouassi Kouamé Léonard,
Yapo Ehounoud C.
Issue:
Volume 3, Issue 5-1, October 2015
Pages:
14-21
Received:
11 June 2015
Accepted:
24 June 2015
Published:
8 July 2015
Abstract: Background and purpose: With a hospital prevalence oscillating between 28% and 32% the strokes represent the first cause of hospitalization in our department [1] Stroke is emerging as a leading cause of preventable death and disability in adults in many developing nations. The general objective was to describe the profile of patients. Problem: The management of stroke is real public challenges under tropic regions. Methodology: We prospectively studied consecutive patients presenting to the neurology unit of Abidjan- Cocody, over a one year period (March 2012-February 2013). The socio-demographic, clinical data, the risk factors as well as the CT scan findings were collected in the patients registers. Results: The hospital prevalence of stroke was 28.3%. The average age was 58 years, and a quarter of patients had less than 50 years. A slight male predominance was noted with a sex ratio of 1.13. The average admission time was 6.7 days and the average period of hospitalization was 10 days. The main risk factor listed was hypertension (79.3%). The percentage of recurrent stroke was 21.6%. The main reasons for admission were: a motor deficit (100%) and headache (88.4%). Computed tomography has allowed the diagnosis of 59% of ischemic stroke especially the MCA territory and 41% of hemorrhagic strokes, mostly basal ganglia. The main causes were, for ischemic stroke, 47% of vascular causes, and hemorrhagic stroke, 74% of micro aneurysms associated with hypertension. Exploration difficulties were responsible for a significant percentage of undetermined causes. We recorded 24.1% of deaths. Conclusion: As in lot of developing African countries, the study suffers from strokes undetermined causes due to lack of financial means, and the failure of the technical platform.
Abstract: Background and purpose: With a hospital prevalence oscillating between 28% and 32% the strokes represent the first cause of hospitalization in our department [1] Stroke is emerging as a leading cause of preventable death and disability in adults in many developing nations. The general objective was to describe the profile of patients. Problem: The ...
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Newborn Stroke in Congo: First Case Report
Gaston Ekouya Bowassa,
Paul Macaire Ossou-Nguiet,
Aymar Pierre Gildas Oko,
Annie Rachel Okoko,
Engoba Moyen,
Nelly Yvette Ngakegni,
Georges Marius Moyen
Issue:
Volume 3, Issue 5-1, October 2015
Pages:
22-24
Received:
8 May 2015
Accepted:
2 September 2015
Published:
16 October 2015
Abstract: Neonatal strokes are defined by the occurrence of any cerebrovascular event between the 20th week of gestation and 28th day after birth. It is an uncommon disease whose incidence varies according to the authors. The localized seizures are the main symptoms. But nonspecific symptoms like bradycardia, bradypnea and poor feeding may reveal the pathology. The diagnosis has been facilitated by the development of brain imaging techniques. It can be done during the acute phase or retrospectively by viewing sequelae’s images. They are characterized by their etiology and therapeutic management that differ from those found in young adults. The prognosis is dominated by the occurrence of neurological sequelae such as epilepsy or motor deficits. We report a case of stroke in the neonatal period, observed on the sixteenth day of life.
Abstract: Neonatal strokes are defined by the occurrence of any cerebrovascular event between the 20th week of gestation and 28th day after birth. It is an uncommon disease whose incidence varies according to the authors. The localized seizures are the main symptoms. But nonspecific symptoms like bradycardia, bradypnea and poor feeding may reveal the patholo...
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