Service de Neurology

La Croix-Valmer, France

Service de Neurology

La Croix-Valmer, France
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Apetse K.,Service de Neurologie | Matelbe M.,Service de Neurologie | Assogba K.,Service de Neurologie | Kombate D.,Service de Neurologie | And 4 more authors.
African Journal of Neurological Sciences | Year: 2011

Aim To study the prevalence of dyslipidemia, hyperglycemia and hyperuricemia in stroke patients to better direct the prophylactic strategies against the stroke. Methods It was a descriptive study carried out in the neurology department at Lome teaching hospital, from January 1st to December 31st 2007. It included 301 patients victims of stroke confirmed by the scanner. Respectively, 221, 280 and 165 reliable measurements of lipidemia, glycemia and uricemia realized on admission were considered. Results The mean glycemia was 1.29 g/l (0.45-5.09 g/l). Glycemia was > 1.25g/l in 86 patients (30.7%). The mean total cholesterolemia (C) was 2.19 g/l (1.09- 4.27 g/l). In 60 patients (27.14%), total C was > 2 g/l. The mean LDL C was 1.50 g/l (0.48-2.85 g/l). In 106 patients (47.96%), LDL C was > 1.50 g/l. The mean HDL was 0.42 g/l (0.15-1.17 g/l) in men and 0.43 g/l (0.10-1.17 g/l) in women. In 91 patients (41.17%), HDL C was < 0.40 g/l. The mean triglyceridemia was 1.19 g/l (0.30-3.35 g/l) in men and 1.21g/l (0.33- 4.05 g/l) in women. In 71 patients (32.12%), triglyceridemia was high. The mean uricemia was 68.52 mg/l (16-137 mg/l) in men and 56.54 mg/l (56-156 mg/l) in women. In 88 patients (53.33%), uricemia was high. Conclusion: There is a strong prevalence of the risk factors studied within stroke patients in Togo. A healthy lifestyle and diet must be the permanent sensitizing object in Togolese populations. © 2002-2012 African Journal of Neurological Sciences.

Oliveira Y.S.,Service de Medecine Physique et de Readaptation | Mandji Lawson J.M.,Service de Medecine Physique et de Readaptation | Mba Angoue J.M.,Service de Medecine Physique et de Readaptation | Okome Obiang I.M.,Service Danesthesie Reanimation | And 3 more authors.
Journal de Readaptation Medicale | Year: 2015

The cerebrovascular accident an acute neurological event, it is a frequent and severe disorder. His coverage establishes (constitutes) a problem of health service in our country. The education of the patients at risk on the symptoms of the AVC and the popularization of the coverage by the units of mobile care and urgencies is necessary. The putting at disposition of financial means for the opening of a centre of functional rehabilitation and rehabilitation specialized is also indispensable. It would allow a coverage adapted by the functional handicap acquired to improve the later lived of the patients reached (affected) by chronic pathologies. We so bring back a study in two phases. The first one is retrospective and descriptive. It concerned 53 accepted patients. © 2015 Elsevier Masson SAS.

Demarquay G.,Service de Neurology | Montavont A.,Groupement Hospitalier Est | Montavont A.,French Institute of Health and Medical Research
Douleur et Analgesie | Year: 2010

Migraine and epilepsy appear as fundamentally different diseases at first sight. However, both of them are characterized by recurrent attacks of nervous system dysfunctions, with a return to baseline between attacks. They share some clinical characteristics such as trigger factors (visual stimuli, sleep deprivation, stress, menses, etc.), enhanced sensitivity for sensory input such as light and sound and transient neurological symptoms including visual, sensory or speech symptoms. The possible occurrence of migrainous headaches before, during some ictal phases of a partial seizure (hemicrania epileptica) or after any seizure (postictal headaches), and the precipitation of an epileptic attack by a typical migrainous aura (migralepsy) also illustrate the reciprocal influences between migraine and epilepsy. Moreover, the alterations of neuronal excitability observed in migraine patients emphasize the debate of a common pathogenic mechanism between the two diseases. The purpose of this review is to present the clinical and pathophysiological similarities between these two disorders. © 2010 Springer-Verlag France.

Guinhouya K.M.,Service de neurology | Aboki A.,Service de neurology | Kombate D.,Service de neurology | Kumako V.,Service de neurology | And 4 more authors.
Cahiers Sante | Year: 2010

Epilepsy, the most common serious neurological condition, is one of the most widespread non-transmissible diseases in the world. In developing countries, about 90% of those with epilepsy do not receive appropriate treatment; this treatment gap, very high compared with other chronic diseases, helps to explain the marginalisation and poor living conditions of these people. Reducing this treatment gap and the burden that epilepsy represents is a difficult task and the obstacles are numerous. The cultural attitudes, the absence of priority for this disease, the weak health infrastructure and the insufficient supply of anti-epileptics are just some of the factors that prevent adequate treatment. The extent of this problem led WHO and the International League against Epilepsy to launch an international campaign in June 1997 to bring epilepsy "out from the shadows". We sought to evaluate a strategy of community-based care for epilepsy in the six pilot districts. This strategy consisted in reducing the treatment gap in six local primary care units (PCUs) and then spreading the programme to surrounding PCUs, the entire district and then the entire region. This prospective evaluation study, which took place from May 2008 to July 2009, applied many strategies. WHO/AFRO made available funding of USD 3500 a year. A training meeting was held for PCU staff and community health agents, and numerous meetings from May 2007 through March 2008 aimed to increase awareness and motivation. The National Program for Mental Health (NPMH) ensured the availability of a permanent supply of anti-epileptics. Monitoring with supervision of activities and evaluation were conducted during and at the end of the process by the members of the Lome ́ Hospital neurology team and the management team of every district. Community-based management of 816 people with epilepsy over a period of 15 months was assessed internally. The planned strategies were conducted. The sex ratio (M/W) was 1.10. Treatment adhesion ranged from 96% to 99%. Mortality was 9%. The treatment gap in the PCUs, which varied from 98% to 94% in May 2008 fell by July 2009, ranging from only 40% to 25%. The "good practice" of accepting and treating patients with epilepsy in these areas where traditional culture excludes them from the community demanded the local acceptance of responsibility - both medical and psychosocial. The reduction in epilepsy attacks and the integration of 2 or 3 patients in a community sufficed to bring other people with epilepsy out from the shadows. These successes show that in developing countries, it is possible to improve the health of different populations when these projects are integrated into primary health care. Positive results, and specifically a treatment gap below 50%, were obtained in all six PCUs. These results, acquired after months of activity, contributed to decrease the stigmatisa-tion of epilepsy. Maintaining this reduction in the treatment gap requires continuation of the struggle against epilepsy and permanent improvement of primary health care. The often unplanned moves of staff and the reluctance of district and regional health managers to allocate resources to the project to perpetuate the programme constitute major difficulties. It appears urgent to adopt an active policy for providing care of patients with epilepsy in Africa in order to increase their lifespan.

Chaari N.,Service de Medecine du Travail et de Pathologie Professionnelle | Chebel S.,Service de Neurology | Mahfoudh A.,Service de Medecine du Travail et de Pathologie Professionnelle | Drira A.,Service de Medecine du Travail et de Pathologie Professionnelle | And 4 more authors.
Annales de Biologie Clinique | Year: 2011

Frequency of the association between non-Hodgkin's lymphoma (NHL) and the hepatitis C virus (HCV) infection is variable according to previous studies. Besides, direct and/or indirect implication of the HCV infection in the development of NHL is probable but, its pathophysiological mechanisms remain unclear. In this report, we described the case of a 49-year-old patient with a B-cell NHL of the sacrum complicating a chronic HCV related to a blood exposure, and we report the recent data of this association. Copyright 2010 American Association for Clinical Chemistry, Inc.

Damelan K.,Service de Neurology | Kom A.,Service de Neurology | Kossivi A.,Service de Neurology | Koffi B.A.,Service de Neurology | And 2 more authors.
Annales de Biologie Clinique | Year: 2010

Hyperhomocysteinemia is an independent vascular risk factor involved in ischaemic stroke. Aim of this study was to evaluate the prevalence of hyperhomocysteinemia and the role of the metabolic determinants in ischaemic stroke. The study concerned 183 patients in the Department of neurology of the teaching hospital of Lome. The diagnosis of stroke was made on clinical and brain CT scan arguments. The dosage of homocysteinemia was carried out by the immunoenzymatic method (Abbott Diagnostic). Among 183 patients, 111 (61%) had a hyperhomocysteinemia. The total average homocysteinemia was of 22.0 μmol/L. The average homocysteinemia among men was of 22.4 μmol/L (5.2-198.0) and 18.80 μmol/L (4.2-50) among women with a positive correlation (P = 0.049 and 0.01) between homocysteinemia and the age among the men and women. The average homocysteinemia was of 17.2 μmol/L in the large ischaemic stroke; 23.0 μmol/L when associated with lacunes and 32.8 μmol/L when associated with lacunes and leucoaraiosis (p = 0.001). In conclusion, the hospital prevalence of the hyperhomocysteinemia was of 61%. Hyperhomocysteinemia was the second vascular risk factor after arterial hypertension in term of prevalence, probably from nutritional cause.

Audoin B.,Service de Neurology | Audoin B.,Aix - Marseille University
Pratique Neurologique - FMC | Year: 2016

The relationship reported between classical magnetic resonance imaging (MRI) metrics (total T2 lesion load and enhancing lesions) and clinical activity (relapses and disability) is usually modest in multiple sclerosis. This may be related to the lack of consideration of lesion location in the majority of published studies, to the characteristics of the disability scale used (EDSS) and to the scarcity of longitudinal studies. Many recent studies taking into account lesion location and/or using longitudinal designs have demonstrated that lesions play a key role in disability accrual at short, middle and long terms. These results highlight the relevancy of conventional MRI to monitor disease activity and response to treatment. In addition, several studies have demonstrated the sensitivity of MRI to monitor occurrence of potential side effects related to treatments. In clinical practice, MRI should be repeated in patients with MS every year and more frequently in some specific situations. © 2016 Elsevier Masson SAS.

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