Polyradiculonevrites Post-Vaccinales a Rechutes Observees en Cote D\Ivoire Recurrent Polyradiculoneuropathies Following Vaccination in Cote D\Ivoire (Francais)
Year: 2003
Type: article
Study design: Case Report
Abstract: Background
Relapsing course of acute inflammatory demyelinating polyneuropathy (AIDP) or chronic inflammatory demyelinating polyneuropathy (CIDP) appears to be unusual. Nosological aspects, unknown pathogenesis and difficulty of treatment are their mainly characteristics.
Objective
The purpose of this paper was to contribute to the epidemiological and clinical study of this disease in comparison with our practice.
Methods
Report of two cases of relapsing polyneuropathy observed in the neurological department of the university hospital of Abidjan, and data review were conducted.
Results
We report a case of recurrent Guillain-Barre syndrome (RGBS) and a case of chronic relapsing variety of Guillain-Barre syndrome in two young africans patients. They recovered from an attack of Guillain-Barre syndrome following a meningococcia A-C vaccination and had respectively acute and chronic relapse. After approximately two years of an asymptomatic interval, they had respectively an acute and a chronic relapse which appeared to be clinically more intensive. CSF protein was normal in one case, and electrophysiological study provided data of demyelinating neuropathy with decreased nerve conduction velocity and motor conduction block. No sural nerve biopsy was performed. There was no evidence of viral infections including HIV, or another disease. Patients were treated during recurrent episode with corticosteroids. One of the two patients recovered very well, while a residual distal motor deficit of lower limbs was observed in the other one.
Conclusion
Meningococcia vaccination was not usually described in the different forms of polyradiculoneuropathy (monophasic or recurrent forms). Corticosteroids appear to be the only treatment available in our country. No singular clinical or electrophysiological data could be emphasized and these two cases are reported because of their rarity. Resume Description
Les formes a rechutes de polyradiculonevrites (PRN) sont des modalites evolutives rares de cette affection. Elles posent a la fois des problemes etiopathogeniques, therapeutiques et nosologiques.
Objectif. Le but de cette etude etait de contribuer a l\'etude epidemiologique et clinique des PRN a rechutes.
Methodes
Il s\'agit d\'une etude de cas clinique concernant des patients hospitalises dans le service de neurologie du CHU de Cocody-Abidjan. Les caracteristiques des cas rapportes sont confrontees aux donnees de la litterature.
Resultats
Nous rapportons deux cas de PRN a rechutes chez deux adolescents noirs africains. Le premier episode est apparu au decours d\'une vaccination antimeningococcique A-C, sous la forme d\'un syndrome de Guillain et Barre d\'evolution favorable. Une rechute a ete observee apres un intervalle libre d\'environ deux ans, sans facteur declenchant identifiable. Le tableau clinique a l\'occasion de ces rechutes etait plus severe avec une atteinte respiratoire. La dissociation albuminocytologique manquait dans un cas, l\'etude electrophysiologique montrait un net ralentissement des vitesses de conduction motrice, une alteration constante de la latence de l\'onde F, associes dans un cas a des signes de degenerescence axonale. Aucunepathologie associee n\'a ete observee et la serologie VIH etait negative. L\'evolution fonctionnelle a ete satisfaisante sous corticotherapie.
Conclusion
Les PRN a rechutes restent rares. Leur traitement rejoint celui des PRN chroniques en accordant une place particuliere et quasi-exclusive a la corticotherapie dans notre contexte. La vaccination antimeningococcique n\'est pas classiquement rapportee dans les PRN post-vaccinales, qu\'il s\'agisse des formes inaugurales ou des formes a rechutes.
(Af. J. of Neurological Sciences: 2003 22(2))
Institution: Centre Hospitalier Universitaire de Cocody
Language: English
Subfield: Clinical Neurology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W2253671808