Moustapha Ndiaye

Magnesium and calcium reduce severity of spatial memory impairments in kainate mouse model of mesial temporal lobe epilepsy.

Calcium and magnesium are divalent multipotent ions playing a major role in metabolism, excitability and neuroglial plasticity. Because of these multiple properties, their deficiency induces complex brain processes leading to acute or even lasting disorders in excitability and neural networks. These ions are usually prescribed in clinical contexts of neuronal hyperexcitability such as preeclampsia and chronic stress. Our aim was to evaluate whether magnesium at 20 mg/kg and calcium at 100 mg/kg could improve the memory prognosis in the kainic model of mesial temporal epilepsy in mice. The animals were organized into 6 groups: control group (without kainate), reference group (GR) without administration of ions, groups treated with magnesium or calcium from the third day (respectively G1m, G1c), groups treated with magnesium or calcium from the third week (respectively G2m, G2c). The mice treated by ions performed better than GR mice, but magnesium was more effective. Memory (short term-long term) was differently affected by kainate or improved by magnesium-calcium. In addition, magnesium demonstrated an increasing therapeutic effect over time while calcium had an acute and apparently decreasing action in the G1c group that received calcium early.

Direct Complication of HIV on the Brain: A Case About a Recurrence of Stroke

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.

Occurrence of Biermer's Disease After 8 Years of Follow-Up of Myasthenia Gravis: About a Clinical Case

The auto immune myasthenia comorbidity and Biermer disease is less documented and rarely brought in the literature. We bring back the observation of a Senegalese patient hospitalized in our department of Neurology at Fann hospital (Dakar). It concerned a patient aged 58 years followed up for auto-immune myasthenia to antibodies anti-receptors of acetylcholine Ac RACH since 8 years and having a benefit of recurrent blood transfusion with a blood group A rhesus positive. He was received on neurologic consultation for a tiredness associated to an effort dyspnea and a gastro esophageal reflux accompanied by vomiting. The interrogatory found palpitations which necessitated a hospitalization two month before. Physical examination had objective a myasthenia syndrome, an anemic syndrome on the other hand, sub icteric mucosa’s were noted but no melanodermia no glossite. The rest of the physical examination was without particularity. The diagnoses of the Biermer illness was carried out in front of the anemic syndrome, the chronicity of the symptomatology without notion of fluctuation and the complementary exams having as objective a low rate of hemoglobin and a deficit in vitamin B12. The origin auto-immune of this anemia was confirmed by the immunologic test which had put in evidence a high rate of anti-bodies anti- intrinsic factor. The patient benefited from a blood transfusion then a treatment from cobalamin (for life) was also installed associated to a symptomatic management of the patient. The evolution after 6 weeks of the treatment was favorable with a complete regression of the dyspnea, vomiting and the attenuation of the effort tiredness. Myasthenia gravis and Biermer disease comorbidity has to be discussed in front of every myasthenia patient presenting clinical signs of effort dyspnea to a chronic anemia because early diagnoses of this association of Biermer illness and myasthenia gravis favors a better prognosis and not to progress to the combined degeneration of the spinal cord. The autoimmune substratum of the mechanism of this comorbidity remains to be elucidated but in all cases multidisciplinary management is necessary.

Diagnosis Approach and Management of Rhombencephalitis: Literature Review

Rhombencephalitis refers to inflammatory diseases of the rhombencephalon. We present here a literature review of this pathology. It was originally described by Edwin Bickerstaff and Philip Cloake in 1951. The terms Rhombencephalitis and trunk encephalitis are interchangeable. It is a rare disease but potentially serious. The symptomatology is characterized, in some cases, by fever and alteration of consciousness, but also headache, nausea and vomiting sometimes. An involvement of the cranial nerves in the majority of the cases and or affected of the long ways. Paraclinically, cerebrospinal fluid and cerebral imaging can be normal in paraneoplastic causes or, on the other hand, be pathological in infectio-inflammatory causes. The etiologies are mainly distinguished in infectious, autoimmune and paraneoplastic pathologies. Treatment should be etiological by anti-infectives (antibiotics, antivirals, etc.) targeting curable germs such as listeria, mycobacterium tuberculosis or herpes, and/or symptomatic by corticosteroid or immunoglobulin IV. Rhombencephalitis is a rare nosological entity but is subject to severe neurological sequelae with a high mortality rate.

Palliative Care Situation in French Speaking African Countries: Example of the Sakoira Integrated Health Center in Republic of Niger (West Africa)

In Niger, palliative care is a necessity in everyday medical practice. However, the setting up of structures and / or mobile teams specifically dedicated to palliative medicine still faces enormous challenges. Most patients who consult for non-communicable disease or specifically for tumors or other incurable illnesses as some neurological diseases come advanced stages, requiring palliative care whereas there is as yet no national structure specifically dedicated to palliative care. No domain of research in palliative care is developed in Niger. No specific scientific work on palliative care have been conducted and published in Niger. This testifies to the lack of promotion of this specialty in Niger. So the ignorance of palliative care, access to morphine and ordinary molecules fight against pain are a real obstacle to the practice of palliative medicine in Sakoira Integrated Health Center (Tillaberi) in republic of Niger.

Myéloradiculite à Schistosoma haematobium : à propos d’une observation à Dakar (Sénégal)@@@Myeloradiculitis due to Schistosoma haematobium: about an observation in Dakar (Senegal)

RésuméLes localisations nerveuses des schistosomoses sont exceptionnelles. Nous rapportons l’observation d’un patient de 25 ans, sénégalais, hospitalisé pour une myéloradiculite d’installation rapidement progressive sur une semaine. Le diagnostic de myéloradiculite à Schistosoma haematobium a été retenu chez ce patient devant la positivité de la sérologie dans le sang, l’isolement des oeufs de S. haematobium dans les urines, l’hyperprotéinorachie, le contexte épidémiologique, la notion de baignades dans de l’eau douce avec antécédents d’hématurie macroscopique et l’absence de toute autre cause. Le patient a bénéficié d’un traitement médical à base de praziquantel et de prednisone et d’une rééducation physique. L’évolution était marquée après six semaines de traitement par une reprise de la marche et une nette régression des troubles génito-sphinctériens. S. haematobium peut entrainer des complications neurologiques invalidantes d’où l’intérêt de sa recherche devant toute paraplégie notamment en milieu tropical.AbstractNervous localisations of schistosomiasis are rare. We report the case of a 25 year-old Senegalese patient admitted for a progressive myeloradiculitis onset, over a one week period. The diagnosis of Schistosoma haematobium myeloradiculitis was made in front of a positive serum serology for S. haematobium, presence of S. haematobium eggs in urine, hyperproteinorachia, endemicity of S. haematobium in the region where the patient was originating and a past medical history of macroscopic hematuria in a context of river bathing. There was also no arguments for another cause to these neurological manifestations. Our patient was treated with praziquantel, prednisone and physiotherapy. Evolution was marked 6 weeks after the beginning of treatment by a significant improvement of motor deficit, enabling the patient to walk again. There was also a regression of genitosphincter dysfunction. Work-up for patients presenting with paraplegia in tropical countries, should also include search for S. heamatobium infection.

Myéloradiculite à Schistosoma haematobium : à propos d’une observation à Dakar (Sénégal)

RésuméLes localisations nerveuses des schistosomoses sont exceptionnelles. Nous rapportons l’observation d’un patient de 25 ans, sénégalais, hospitalisé pour une myéloradiculite d’installation rapidement progressive sur une semaine. Le diagnostic de myéloradiculite à Schistosoma haematobium a été retenu chez ce patient devant la positivité de la sérologie dans le sang, l’isolement des oeufs de S. haematobium dans les urines, l’hyperprotéinorachie, le contexte épidémiologique, la notion de baignades dans de l’eau douce avec antécédents d’hématurie macroscopique et l’absence de toute autre cause. Le patient a bénéficié d’un traitement médical à base de praziquantel et de prednisone et d’une rééducation physique. L’évolution était marquée après six semaines de traitement par une reprise de la marche et une nette régression des troubles génito-sphinctériens. S. haematobium peut entrainer des complications neurologiques invalidantes d’où l’intérêt de sa recherche devant toute paraplégie notamment en milieu tropical.AbstractNervous localisations of schistosomiasis are rare. We report the case of a 25 year-old Senegalese patient admitted for a progressive myeloradiculitis onset, over a one week period. The diagnosis of Schistosoma haematobium myeloradiculitis was made in front of a positive serum serology for S. haematobium, presence of S. haematobium eggs in urine, hyperproteinorachia, endemicity of S. haematobium in the region where the patient was originating and a past medical history of macroscopic hematuria in a context of river bathing. There was also no arguments for another cause to these neurological manifestations. Our patient was treated with praziquantel, prednisone and physiotherapy. Evolution was marked 6 weeks after the beginning of treatment by a significant improvement of motor deficit, enabling the patient to walk again. There was also a regression of genitosphincter dysfunction. Work-up for patients presenting with paraplegia in tropical countries, should also include search for S. heamatobium infection.