Neuromyelitis Optica Spectrum Disorders: A Preliminary Study of 33 Cases at the Neurology Department of Fann Teaching Hospital in Dakar (Senegal)
Ndiaga Matar Gaye1, Mamadou Ka1, Alassane Mamadou Diop1, Adjaratou Dieynabou Sow1, Moustapha Ndiaye1, Amadou Gallo Diop1
1Neurology department of Fann Teaching Hospital
Objective:
Our study aim was to describe the diagnostic, therapeutic and outcome aspects of Neuromyelitis optica spectrum disorders (NMO-SD) cases diagnosed in Dakar.
Background:
Neuromyelitis optica spectrum disorders is a disabling neuroinflammatory disease which is rarely described in sub-Saharan Africa where its prevalence would be higher.
Design/Methods:
This was a retrospective and prospective descriptive study conducted at the Neurology Department of Fann Teaching Hospital in Dakar (Senegal) between January 2011 and December 2019. All patients who meet the 2014 NMO-SD diagnostic criteria were included.
Results:
Thirty-three patients (28F/5M) with an average age of 31 years +/- 11 were enrolled. Twenty patients (60.6%) had previous attacks with a mean diagnosis delay of 55 months. Twenty patients (60.6%) had myelitis associated with retrobulbar optic neuritis (RON), 9 patients (27.2%) had isolated myelitis and 2 patients had isolated RON. Eight patients (24.4%) had area postrema syndrome and 2 patients (6.1%) had mental confusion and hypersomnia. Spinal cord MRI showed longitudinally extensive myelitis in 28 patients (84.8%), with bulbo-cervical (14.2%), cervical (28.5%), cervicodorsal (42.8%) or dorsal (14.2%) topography. Brain MRI signal abnormalities were present in 5 patients (15.1%). Anti-AQP-4 antibodies were positive in 27 patients (81.8%), negative in 2 patients (6.1%), and not measured in 4 patients (12.1%). Methylprednisolone was used in 10 patients (30.3%), prednisone in 31 patients (93.9%) and azathioprine in 27 patients (81.8%). The mean Expanded Disability Status Scale, evaluated at 3 months in 17 patients (51.5%) was 6.5.
Conclusions:
Since the publication of the first senegalese series in 2019, the number of diagnosed cases of NMO-SD has increased over time.