Multiple Sclerosis in West Africa, about a Case Confirmed at Ouagadougou, Burkina Faso

Abstract

Introduction: Multiple sclerosis (MS) is the main demyelinating inflammatory disease of the central nervous system. It usually affects young female adults between 20 and 40 years old, during professional activity period. Diagnosis is based on combination of the clinical presentation, the white-matter abnormalities on MRI, the CSF and the evoked potentials, making differential diagnosis of MS. Treatment of MS intend to prevent relapses and to delay progressive aggravation of the disease. Through this case report, the authors show that multiple sclerosis is a disease present in sub-Saharan Africa. Case presentation: This is a case report of a 25-year-old Burkinabe, hospitalized in the department of neurology on 13th September 2014 for motor deficit of the four limbs developing progressively without fever over three weeks. The medical history found diffuse paraesthesias described as tingling of the four limbs to the flexion of the neck, a decline in visual acuity of the left eye, a slowing of walk speed, dysarthria and sphincter disorders like urinary urgency. Neurological examination revealed a predominantly proximal spastic tetraparesis with bilateral Babinski sign; cerebellar dysfunction with dysarthria, enlargement of the polygon and kinetic ataxia of upper limbs, swallowing disorders and lingual atrophy. The lumbar puncture showed a clear cerebrospinal fluid, at normal pressure, increased cell count with 8 cells /ml and a normal glycorrhachia. On cerebral and spinal MRI, there were diffuse hyper-intensities which met the criteria of Bancroft and of MacDonald supporting multiple sclerosis diagnosis. The clinical course was favorable under corticosteroid therapy after 30 days of hospitalization. Conclusion: Multiple sclerosis is a rare neurological disease in the black African. The discovery of a case in Burkina Faso shows the importance of carrying out radiological assessment in every case of acute myelitis occurring in the young people.