Epidemiologie Et Devenir Des Paraplegiques Reeduques Au Cnhu De Cotonou

Description Si dans les pays industrialises, le pronostic vital, les capacites fonctionnelles et l\'esperance de vie des paraplegiques se sont ameliores, en Afrique, leur devenir est encore incertain. Objectif Analyser le devenir des paraplegiques suivis en reeducation hospitaliere a Cotonou de 1999 a 2003, et apres retour a domicile. Methode c\'est une etude retrospective, descriptive portant sur 40 paraplegiques adultes traites de 1999 a 2003 et reexamines en fevrier 2004 pour evaluer leur devenir. Resultats 65% des patients etaient hommes et 35% de femmes de sex-ratio 1,8 et d\'âge moyen 42, 8 ans,. Les etiologies sont dominees par le traumatisme (37,5%), les tumeurs (22,5%), la hernie discale operee (22,5%). 57,5% des patients ont presente des troubles vesicosphincteriens. Spasticite et escarres ont ete frequentes chez les patients. Les niveaux lesionnels medullaires (thoraciques et lombaires hauts) ont ete de 50% et queue de cheval 50%. Neuf mois a trois ans apres leur retour a domicile, 32,5% des patients sont decedes dont 69% de causes tumorales. Parmi les survivants, 18,5% ont marche ; 28,5 % avec appareillage, 52% condamnes au fauteuil roulant. Le retour a domicile avec la participation de la famille a ete possible pour 92% ; mais 66,7% des survivants n\'ont joui ni de reconversion ni de reinsertion professionnelle. Conclusion Le devenir des paraplegiques reeduques au CNHU de Cotonou a ete fortement marque par l\'issue fatale. Aux survivants se sont poses des problemes de reinsertion professionnelle dont la resolution depasse le cadre restreint de la solidarite africaine. Background If in industrialized countries, vital prognosis, functional capacities and life expectancy of paraplegics improved, their becoming is still unsettled in Africa. Objective to analyse the becoming of patients with paraplegia rehabilitated at CNHU in Cotonou, from 1999 to 2003 and after their returning back home. Method It is a retrospective study aimed to be descriptive, done with 40 adults with paraplegia, followed from 1999 to 2003 and seen again in February 2004 to appreciate their becoming. Results 65% of patients were men and 35% women; sex-ratio about 1.8 and 42.8 years as average age; most of them still being in professional activity. Aetiologies were prevailed by traumatism (37. 5%), tumor (22. 5%) and operated discal hernia (22. 5%). On 57. 5% cases, urinary disorders were present with paraplegia. Spasticity and eschars were frequently developed by patients. Levels were spinal cord injuries (thoracic and lumbar high) 50% and ponytail 50%. Nine months to three years after their returning back home, 32. 5% of patients died, 69 % of them with neoplasia. 18. 5% of survivors were able to walk, 29. 5% with artificial limb supply, 52% condemned to use wheel chair. Returning back home with the participation of the family was possible for 92% of patients. Neither professional reinsertion nor reconversion was possible for 66. 7% of survivors. Conclusion Becoming of patients with paraplegia rehabilitated at CNHU in Cotonou has been marked strongly by the fatal exit. Problems of professional reinsertion whose resolution passes the restrict setting of African solidarity arose to the survivors. Keywords : Benin, epidemiology, evolution, paraplegia, rehabilitation African Journal of Neurological Sciences Vol. 26 (2) 2007: pp. 58-65