GENERAL PARALYSIS IN A TROPICAL COUNTRY. STUDY OF 43 OBSERVATIONS

PARALYSIE GENERALE EN MILIEU TROPICAL. ETUDE DE 43 OBSERVATIONS RESUME Description :Les auteurs rapportent une etude de 43 cas de paralysie generale, reveles par un syndrome dementiel et des formes atypiques notamment les troubles confusionnels repetitifs et des crises epileptiformes. Objectif : L'objectif de cette etude est de reevaluer cette pathologie du point de vue clinique et paraclinique en milieu tropical. Methode : Il s'agit d'une etude prospective. Le diagnostic a repose sur la positivite des reactions serologiques ( VDRL-TPHA) dans le sang et le liquide cephalo-rachidien, la presence d'une hypercellularite a predominance lymphocytaire et d'une hyperproteinorachie. Resultats : Les troubles cognitifs et moteurs, les etats confusionnels repetitifs et les crises epileptiques constituent les formes cliniques dominantes de debut. Chez tous les patients, le scanner a mis en evidence une discrete dilatation ventriculaire diffuse et un elargissement des sillons de la convexite. Le trace electroencephalographique etait anormal dans pres de 67% des cas. SUMMARY Description : The authors report a study of 43 cases of general paralysis revealed by some mental disorders and atypical forms notably repeater confessional disorders and some seizure-like attacks. Objective : The goal of this study is to revalue this pathology from the clinical and paraclinic point of view in tropical medium. Method : In this prospective study, the diagnosis was based on the serologic tests (VDRL-TPHA) in the blood and the cerebrospinal fluid (CSF); CSF cell count with lymphocyte predominance ; protein level in the fluid. Result : The diagnosis was based on the serologic tests (VDRL-TPHA) in the blood and the cerebrospinal fluid(CSF); high CSF cell count with lymphocyte predominance; high protein level in the fluid. The cogniture and motor troubles, the repeated confusion status and the epileptic seizures constitute the dominant clinical forms of the onset. In all the patients, the CT-scan revealed discrete diffuse ventricular dilation and widening of the grooves of the convexity. The electroencephalographic traces were abnormal in 67% of the cases. Key Words: Afrique, Guinee, paralysie generale, syphilis nerveuse, Africa, Guinea, general paralysis, neurosyphilis African Journal of Neurological Sciences Vol.23(2) 2004