BACKGROUND:Traditional health practitioners (THP) and complementary and alternative medicines (CAM) play a well-recognized role in Africa. However, their role in treating movement disorders (MD) remains poorly studied. OBJECTIVE:This large multicenter continental study aimed to investigate the prevalence of seeking and consulting THPs and using CAMs among people with MDs in different African countries and the associated factors of their use. METHODS:This study involved 12 sites within 11 African countries. We developed and distributed a structured questionnaire that documented frequency, attitudes, beliefs, and factors related to patients' engagement with THPs and use of CAMs. RESULTS:We surveyed 1158 participants with MDs from 11 African countries in different regions of the continent. Overall engagement with THP and CAM use were reported in about a third (319 [27.5%] and 356 [30.7%], respectively) of individuals with MDs, which was associated with delayed diagnosis and medical treatment initiation and significantly varied by country, reaching up to 80%, particularly among individuals from sub-Saharan Africa (SSA) and those with hyperkinetic MDs. Common contributing factors included unavailability, unaffordability, and lack of access to health services; misconceptions regarding disease nature; lack of curative response to medications; feeling of stigma; rural residence and patients' ethnicity; and levels of education and employment. These factors were more pronounced in patients in SSA. CONCLUSION:Seeking THPs and using CAM are widespread practices in African countries and have a negative impact on patients' care. Their use is related to inadequate health-care services, misconceptions, and other factors, which are modifiable and mandate immediate and comprehensive actions. © 2026 International Parkinson and Movement Disorder Society.

Non-motor symptoms (NMS) are common in Parkinson’s disease (PD). They contribute significantly to changes in patients’ quality of life (QOL). To assess the impact of NMS on the QOL of patients with PD in Senegal. We conducted a cross-sectional study from January to August 2024. All patients who met the diagnostic criteria for PD and were followed up in the neurology department at the Pikine National Hospital Center were included. NMS were assessed using the Movement Disorders Society-Non-motor Symptoms Scale (MDS-NMS), while QOL was assessed using the 39-item Parkinson’s Disease Questionnaire (PDQ-39). The Hoehn and Yahr scale was used to determine the disease stage for each patient. The student’s t-test was used to compare quantitative variables, and linear regression was used to identify predictive factors for poor QOL. A total of 52 patients with PD were enrolled. The mean age was 64.6 ± 10 years. The mean MDS-NMS score was 61.8 ± 30.48. The most prevalent NMS were sleep disturbance (98

BACKGROUND:Limited data is available about the availability of multiple sclerosis (MS) therapies and services in Africa. OBJECTIVE:We aimed to investigate the availability, affordability, frequency of usage, and insurance coverage of MS therapies and services across Africa. METHODS:A comprehensive web-based survey was constructed and distributed to neurologists from different African countries. The survey addresses availability, affordability, frequency of use, and insurance coverage of different therapies and services of MS. RESULTS:Respondents represented 27 African countries. Intravenous methylprednisolone was always available in most countries (88.9%), while interferons were completely or partially available in 13 countries (48.1%). The most available disease-modifying therapies (DMTs) were rituximab (22 countries, 81%), followed by interferon beta 1a intramuscular type (12, 44.4%). Availability of other DMTs was variable, while specific MS services were limited. Affordability is limited in most countries, and the use of DMTs was related to insurance coverage. Most associated therapies and investigations were more available and affordable, but less insured. Neurologists were the main healthcare providers, but traditional healers had a role in 14.8% of countries. CONCLUSION:Significant challenges characterize MS care in Africa. MS therapies, particularly DMTs and services, are inaccessible and unaffordable in most African countries.

Introduction: Neurological complications related to human immunodeficiency virus (HIV) infection can occur at all stages of the disease. Objective: To describe the epidemiological, clinical and evolutionary aspects of patients who have presented neurological complications of HIV followed at the neurology department of the CHN of Pikine. Methodology: This is a cross-sectional study from January 2023 to August 2023 on a population of patients living with HIV followed in the Neurology Department of the National Hospital Center of Pikine. Results: Sixteen patients were collected, including eight men. The average age is 43.75 years old. The most frequent reasons for consultation were fever (68.75%), followed by headache (62.5%) and motor deficit (37.5%). Somatically, pyramidal syndrome was the most common neurological manifestation (62.5%), followed by meningeal syndrome (50%) and delirium syndrome (37.5%). Considering the WHO classification, WHO stage 4 was the most represented clinical stage. It was noted in 8 patients. HIV-1 and HIV-2 positive patients numbered 14 (87.5%) and 1 (6.25%) respectively. A co-infection of HIV1 and 2 was noted in only one patient. The main associated neurological disorders were dominated by viral encephalitis and meningoencephalitis (43.75%), cerebral toxoplasmosis (25%) and neuromeningeal tuberculosis (25%). The CD4 count was available in 11 patients (68.75%), with an average of 227.18 cells/mm3. The CSF biochemical study showed normoglycorachia in 11 patients (68.45%) and hypoglycorachia in 4 patients (25%). The cytology study of the CSF showed normal cellularity in 2 patients, lymphocytic hypercellularity in 12 patients (75%). The CT scan was performed in 11 patients, i.e. 68.8%. It returned normal in 4 patients. The main CT diagnoses were dominated by toxoplasmosis with roundel images (18.75%). Death occurred in 7 patients (43.75%). Conclusion: Neurological complications are frequent and serious during HIV infection. They require early diagnosis and appropriate treatment in order to avoid late treatment responsible for very high mortality. Keywords: Neurological complications, HIV/AIDS, CHN of Pikine.

Huntington Disease-like (HDL) is a neurodegenerative disorder similar to Huntington Disease (HD) in its clinical phenotype, genetic characteristics, neuropathology and longitudinal progression. We review the different phenocopies of HDL in Africa from a clinical and genetic perspective through published cases. A literature review through PubMed and Google Scholar of all clinically and genically described cases of HDL until the end of December 2022 was performed and a descriptive analysis was carried out. Fifteen papers were published from 2000 to 2022 in Africa on HDL. Only HD phenocopies caused by mutation of the following genes (JPH3, ATXN2, VPS13A, VPS13D, PRNP, NBIA, ATN1, ATM) were described. The most representative phenocopies was HDL2 (JPH3) described in case series and families in South Africa. Other phenotypes and genotypes are described either as case series or isolated clinical cases. This review clarifies some aspects of the phenotype and genotype of HDL, mainly HDL2, and highlights others in Africa that require further research.

Introduction The coexistence of Moyamoya syndrome and Graves’ disease is rare, particularly in sub-Saharan Africa. We report a case of Moyamoya syndrome associated with Graves’ disease, revealed by an acute ischemic stroke. Patient and observation We present the case of a 45-year-old woman admitted for sudden-onset left-sided hemiparesis and speech impairment. Her medical history included anxiety-depressive disorders, chronic headaches, sleep disturbances, and progressive weight loss. On admission, clinical examination revealed physical asthenia, bilateral pyramidal syndrome, a stage 1 goiter, and regular tachycardia. Brain MRI with angiography showed bilateral FLAIR hyperintensities in the watershed territories of the anterior and middle cerebral arteries, with diffusion restriction and decreased ADC values. Cerebral vascular imaging revealed bilateral occlusion of the terminal internal carotid arteries and middle cerebral arteries, along with narrowing of the anterior, posterior cerebral arteries and the vertebrobasilar system. Cerebrospinal fluid analysis was normal. Ultrasensitive TSH was nearly undetectable. Graves’ disease was suspected based on the presence of hyperthyroidism and significantly elevated anti-TSH receptor antibodies (3.79 IU/L). The vascular lesion pattern observed on cerebral angio-MRI was consistent with stage 1 Moyamoya syndrome according to the Suzuki classification. Conclusion Ischemic strokes are common in Moyamoya syndrome associated with Graves’ disease, particularly in the context of thyrotoxicosis.

BACKGROUND:Africans are underrepresented in Huntington's disease (HD) research. A European ancestor was postulated to have introduced the mutant Huntingtin (mHtt) gene to the continent; however, recent work has shown the existence of a unique Htt haplotype in South-Africa specific to indigenous Africans. OBJECTIVE:We aimed to investigate the CAG trinucleotide repeats expansion in the Htt gene in a geographically diverse cohort of patients with chorea and unaffected controls from sub-Saharan Africa. METHODS:We evaluated 99 participants: 43 patients with chorea, 21 asymptomatic first-degree relatives of subjects with chorea, and 35 healthy controls for the presence of the mHtt. Participants were recruited from 5 African countries. Additional data were collected from patients positive for the mHtt gene; these included demographics, the presence of psychiatric and (or) cognitive symptoms, family history, spoken languages, and ethnic origin. Additionally, their pedigrees were examined to estimate the number of people at risk of developing HD and to trace back the earliest account of the disease in each region. RESULTS:HD cases were identified in all countries. Overall, 53.4% of patients with chorea were carriers for the mHTT; median tract size was 45 CAG repeats. Of the asymptomatic relatives, 28.6% (6/21) were carriers for the mHTT; median tract size was 40 CAG. No homozygous carries were identified. Median CAG tract size in controls was 17 CAG repeats. Men and women were equally affected by HD. All patients with HD-bar three who were juvenile onset of <21 years-were defined as adult onset (median age of onset was 40 years). HD transmission followed an autosomal dominant pattern in 84.2% (16/19) of HD families. In familial cases, maternal transmission was higher 52.6% (10/19) than paternal transmission 36.8% (7/19). The number of asymptomatic individuals at risk of developing HD was estimated at ten times more than the symptomatic patients. HD could be traced back to the early 1900s in most African sites. HD cases spread over seven ethnic groups belonging to two distinct linguistic lineages separated from each other approximately 54-16 kya ago: Nilo-Sahara and Niger-Congo. CONCLUSION:This is the first study examining HD in multiple sites in sub-Saharan Africa. We demonstrated that HD is found in multiple ethnic groups residing in five sub-Saharan African countries including the first genetically confirmed HD cases from Guinea and Kenya. The prevalence of HD in the African continent, its associated socio-economic impact, and genetic origins need further exploration and reappraisal.

Introduction: Quality of life in Parkinson disease is not necessary linked to motor symptoms.It's correlated of overactive bladders and prostatic symptoms.Prognosis factors of urinary quality of life are unknown.Objectives: Our study aims to find prognosis factors of quality of life associated specifically of urinary disorders in PD.Patients and methods: We conducted a transversal, analytic and descriptive study in Physical Medicine, and Neurology departments, Fann Teaching Hospital, Dakar and included patients followed for treatment of PD.Urinary disorders, quality of life and functional autonomy were assessed respectively by Urinary Symptoms Profile (USP), Qualiven Short Form, Schwab and England Scale.Results: 38 patients presented PD, with a mean age of 60.89 ± 13.6 years and sex-ratio of 2.45.Mean duration of PD was 3.1 ± 2.9 years.Urinary disorders were found in 47.36% and dominated by incontinence (88.88%) and overactive bladders (88.88%) which were minor in more than 55%.Quality of life was impaired in 88.88% of cases.Minor forms (43.75%) were predominant and constraint dimension (50%) was the most severely altered.Prognosis factors for quality of life of urinary disorders were PD stages (0.046) and functional autonomy (0.042).Discussion and conclusion: Urinary disorders in PD are common, impaired quality of life, especially the constraint dimension, depends on stage of evolution of PD and functional autonomy of patients.

Introduction:The new coronavirus constitutes a public health problem due to its many often fatal complications such as thromboembolic diseases.Upper this infectious state, neurological diseases are reported mainly ischemic stroke and rarely cerebral venous thrombosis.Observation: We report the case of a 76-year-old diabetic, hypertensive patient who was well monitored and who presented neurological manifestations 24 hours after home returning from hospitalization for COVID 19 infection fifteen days before.Major signs were dehydration grade I according to the WHO, confusional syndrom, left pyramidal syndrom of cortical type predominantly on facial and arm and regular tachycardia.The brain imagery revealed a double thrombus in sinus and diagnosis of cerebral thrombosis (CVT) was made.Biological abnormalities were noted, such as neutrophilic hyperleukocytosis and thrombocytopenia.The evolution was favorable with symptomatic treatment and after putting on oral curative dosis anticoagulant.Conclusion: Cases of cerebral venous thrombosis are increasingly reported in the literature, but Cases of CVT in the field COVID 19 remain rare, especially in Africa.Elderly age and vascular risk factors could favorite occurrence of cerebral venous thrombosis in cases of Sars-Cov infection.It is important to think about it in the face of any brain neurological picture given the thrombogenic nature of COVID 19, mainly in geriatric population.However, guidelines must been done for better management of these patients even if outcomes evolution are generally favourable.

Introduction Parkinson’s disease (PD) has become a global public health challenge as disability and death due to the disease are growing rapidly in comparison to other neurological disorders. There are no up-to-date comprehensive reviews on the epidemiology, environmental and genetic risk factors, phenotypic characterization, and patient-reported outcomes of PD in Africa. This data is crucial to understanding the current and future burden and suggesting actionable and/or researchable gaps aimed at improving disease outcomes.Methodology We conducted a systematic literature search using the electronic databases of Cochrane Central Register of Controlled Trials (CCRT), EMBASE, Medline, PsychINFO, Web of Science, Cumulative Index to Nursing and Allied Health Literature (CINAHL), African Journals (AJOL) and other unpublished literature. We included all studies providing data on people with PD in Africa from the start of each database till February 2023. Studies were not restricted based on diagnostic criteria or language. Outcomes of interest were summarised based on epidemiology, genetics, environmental risk factors, clinical characteristics, patient-reported outcomes (experience and quality of life), disease management and outcomes, access to care, patient support, and healthcare workforce training. We also investigated collaboration between African countries (internal) and across continents/world regions (external) and journal impact factors.Results A total of 4,855 articles were identified, of which 180 were included in this review. The majority were published from North Africa (mainly from Tunisia, and involved collaboration with investigators from France, the United Kingdom, and the United States of America). West Africa (Nigeria), Southern Africa (South Africa) and East Africa (mainly Tanzania) also had a relatively high number of publications. Methodological design varied across studies. Based on the pre-determined outcomes, articles identified were genetics (67), clinical features (65), environmental risk factors (16), epidemiology (14), patient experience and quality of life (10), management and access to care (5) and education and training (3).Conclusions The main hubs of PD-related research output in Africa are the Northern, Western and Southern regions of Africa (although with limited involvement of countries within these regions). External collaboration (outside the continent) currently predominates. There are considerable actionable and researchable gaps across all outcomes of interest, with a dearth of published information on health workforce capacity building, disease management and access to care, patient and caregiver engagement, and quality of life of people with PD in Africa. We recommend strengthening existing and emerging intercontinental networks for research, education, training and policy formulation and funding, leveraging on more recent developments such as the International Parkinson’s Disease Genomics Consortium-Africa (IPDGC-Africa), the International Parkinson and Movement Disorder Society Africa Section (MDS-AS), World Health Organisation (WHO) and initiatives with similar objectives.### Competing Interest StatementThe authors have declared no competing interest.### Funding StatementThis research did not receive any form of funding.### Author DeclarationsI confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.YesI confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals.YesI understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).YesI have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable.YesAll data generated or analysed during this study are included in this published article (and its supplementary information files).

Background A wide variety of movement disorders can be observed after cerebral hypoxia, including akineto-hypertonic syndrome and dystonia. Post-anoxic dystonia is a rare clinical syndrome that is not widely reported in the literatures. It is thought to be related to cerebral hypoxia leading to ischaemia of the basal ganglia. Case description We report a case of an 11-year-old girl who represented with generalized dystonia following resuscitation from a cardiac arrest after open heart surgery. Brain MRI showed basal ganglia hypersignals in T2-FLAIR (fluid attenuated inversion recovery) weighted sequence and in the diffusion sequence without restriction of ACD in favour of subacute ischemic lesions. Treated with oral baclofen, the evolution was favourable with regression of the dystonia. Conclusion It is often difficult to accurately predict the final neurological outcome of a patient who has survived cardiac arrest. Baclofen and anticholinergic can be used for the treatment for dystonia post-cerebral hypoxia.

The data that support the findings of this study are available from the corresponding author upon reasonable request. Appendix S1. Supplementary tables Appendix S2. Education Research Africa Survey Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.

Eagle syndrome is a set of clinical and radiological signs related to calcification of the stylohyoid ligament. We report 2 cases of patients who came to consult for intermittent laterocervical pain. The cervical and petrous CT scan performed in the patients showed a bilateral long styloid process. A medical treatment based on carbamazepine and paracetamol was initiated in both patients with good clinical evolution and significant reduction in pain intensity. Eagle syndrome is a rare pathology that should not be ignored by the doctor, in order to avoid diagnostic and therapeutic errors. French Abstract Le syndrome d’Eagle est un ensemble de signes cliniques et radiologiques en rapport avec une calcification du ligament stylo-hyoïdien. Nous rapportons ici deux cas cliniques de deux femmes âgées respectivement, de 26 et 36 ans ayant consulté pour des douleurs latérocervicales. Le scanner cervical et du rocher réalisé chez les patients a montré un aspect de longue apophyse styloïde bilatérale. Un traitement médical à base de carbamazépine et paracétamol a été initié chez les deux patientes et a conduit à une réduction significative de l’intensité de la douleur. Le syndrome d’Eagle est une pathologie rare qui ne doit pas être méconnu par le médecin, afin d’éviter les errances diagnostiques et thérapeutiques. Mots-clés : Douleur cervicale ; syndrome d’Eagle ; Apophyse styloïde

L’hématidrose est décrit comme un trouble de la sécrétion sudorale caractérisé par la présence de globules rouges, de leucocytes et de plaquettes dans la sueur. Elle s’inscrit volontier dans le contexte d’un épisode de stress émotionnel intense . Elle peut s’associer à des manifestations cliniques paroxystiques stéréotypées pouvant évoquer des crises épileptiques. Nous rapportons le cas d’une jeune adolescente, suivie pendant longtemps pour des supposées crises épileptiques, chez qui la survenue d’une hématidrose dans un contexte de stress familial intense a permis de poser le diagnostic de crises psychogènes non épileptiques.