Background Electroencephalography (EEG) is a fundamental diagnostic tool used to evaluate epilepsy and other neurological disorders. Despite its clinical relevance, access to EEG services remains highly constrained across Africa, owing to infrastructure and workforce limitations. Objective To assess the current state of EEG services in Africa, including availability, distribution, usage patterns, and barriers to access, and to propose strategic recommendations for expanding coverage and utilization. Methods A cross-sectional online survey was conducted between 1st June and December 31, 2025, using a structured questionnaire distributed to different practitioners across 54 African countries. Responses were analyzed using descriptive statistics to evaluate EEG access, infrastructure, training availability, and international collaborations. Results A total of 108 respondents from 42 African countries participated in the study. Most countries reported between 1 and 10 EEG machines nationally, corresponding to fewer than 0.4 devices per million population in most sub-Saharan countries, compared with over six devices per million in parts of North Africa. More than 55% of EEG machines were concentrated in capital cities. Only 8.6% of respondents used tele-EEG, and fewer than 22% reported cross-border collaboration. Routine EEG was widely available, while video-EEG and advanced modalities were rare. Limited training opportunities and workforce shortages are major constraints. Conclusion There is an urgent need for a continent-wide EEG strategy to address diagnostic and training inequities. Key priorities include decentralizing services through mobile and tele-EEG systems, establishing standardized training pathways, and promoting international collaborations. Strategic investment is essential for equitable neurodiagnostic services in Africa.

A polygenic score (PGS) for Alzheimer's disease (AD) was derived recently from data on genome-wide significant loci in European ancestry populations. We applied this PGS to populations in 17 European countries and observed a consistent association with the AD risk, age at onset and cerebrospinal fluid levels of AD biomarkers, independently of apolipoprotein E locus (APOE). This PGS was also associated with the AD risk in many other populations of diverse ancestries. A cross-ancestry polygenic risk score improved the association with the AD risk in most of the multiancestry populations tested when the APOE region was included. Finally, we found that the PGS/polygenic risk score captured AD-specific information because the association weakened as the diagnosis was broadened. In conclusion, a simple PGS captures the AD-specific genetic information that is common to populations of different ancestries, although studies of more diverse populations are still needed to better characterize the genetics of AD.

INTRODUCTION:The LIfestyle for BRAin Health (LIBRA) index yields a dementia risk score based on modifiable lifestyle factors and is validated in Western samples. We investigated whether the association between LIBRA scores and incident dementia is moderated by geographical location or sociodemographic characteristics. METHODS:We combined data from 21 prospective cohorts across six continents (N = 31,680) and conducted cohort-specific Cox proportional hazard regression analyses in a two-step individual participant data meta-analysis. RESULTS:A one-standard-deviation increase in LIBRA score was associated with a 21% higher risk for dementia. The association was stronger for Asian cohorts compared to European cohorts, and for individuals aged ≤75 years (vs older), though only within the first 5 years of follow-up. No interactions with sex, education, or socioeconomic position were observed. DISCUSSION:Modifiable risk and protective factors appear relevant for dementia risk reduction across diverse geographical and sociodemographic groups. HIGHLIGHTS:A two-step individual participant data meta-analysis was conducted. This was done at a global scale using data from 21 ethno-regionally diverse cohorts. The association between a modifiable dementia risk score and dementia was examined. The association was modified by geographical region and age at baseline. Yet, modifiable dementia risk and protective factors appear relevant in all investigated groups and regions.

Introduction: The diagnosis of restless legs syndrome (RLS) is an exclusively clinical diagnosis which is based on questioning the patient. Furthermore, several pathologies can mimic the symptoms of RLS. It should also be emphasized that small fiber neuropathies (SNF) escape electroneuromyography (ENMG) since this examination essentially studies large diameter myelinated fibers. The objective of this study is to assess the contribution of skin biopsy on the one hand in the differential diagnosis of RLS when an associated pathology may be responsible for NPF and on the other hand in the diagnosis of RLS with tone very painful. Patients and Methods: We carried out a prospective study covering the medical files of 2 patients followed in consultation at the Limoge University Hospital for RLS, one of whom had a systemic disease and the other had RLS evolving since then through attacks. unbearably painful. Each patient underwent a clinical evaluation based on the diagnostic criteria for RLS, an ENMG and a skin biopsy. Results: For each patient, the diagnosis of RLS was confirmed by the presence of four diagnostic criteria. Patient 1 had an IRLS score of 30/40, a normal ENMG and a normal skin biopsy with normal FNIE density. Patient 2 had RLS with a very painful tone, a normal ENMG and a skin biopsy showing rarefaction of FNIE proximally and distally, and concomitant rarefaction of subepidermal fibers. Conclusion: This study, considered preliminary with a limited sample, does not allow us to achieve the objective. A longitudinal study with a satisfactory sample could allow us to elucidate the question.

The authors report a case of deficient sensory neuropathy secondary to vitamin B12 deficiency, diagnosed in the neurology department of the Sino-Central African Friendship University Hospital in Bangui. The diagnosis was made possible by electroneuromyography which showed subclinical neurological damage associated with hematological damage (anemia). Through this observation, we recall the diagnostic criteria of the disease in a context of difficult medical practice.

AbstractDementia is a global public health problem with increasing prevalence and incidence worldwide. The African continent is expected to bear the biggest brunt of the burden of dementia by 2050 because of the rapid demographic changes, including rapid population growth, an increase in life expectancy, and ageing. However, French-speaking Sub-Saharan African (FS-SSA) countries are underrepresented in research on dementia in Africa. While the reasons are diverse and complex, linguistic and cultural barriers to research, disproportionately affect these countries and may be significant factors. Any efforts, therefore, to redress the burden of dementia in Africa must consider the specific demographic, cultural, and linguistic characteristics of FS-SSA countries. This scoping review explores the current state of knowledge in dementia and cognitive impairment in Sub-Saharan Africa, highlighting research gaps and specific patterns unique to FS-SSA Africa. We identify pathways for research to bridge the knowledge gaps on dementia in FS-SSA as part of the global endeavor to tackle dementia worldwide.

We built a genetic risk score (GRS) from the most complete landscape of the Alzheimer disease (AD) genetics. We extended its analysis in 16 European countries and observed a consistent association of this GRS with AD risk, age at onset and cerebrospinal fluid (CSF) AD biomarker levels regardless of theApolipoprotein E (APOE)genotype. This GRS was also associated with AD risk (independently ofAPOE) with a decreasing order of magnitude in those with an European-American, North-African, East-Asian, Latin-American, African-American background respectively. No association of the GRS to AD was seen in sub-Saharan African and Indian populations. This GRS captures information specific to AD as its association decreases as the diagnosis broadens. In conclusion, a simple GRS captures shared genetic information specific to AD between multi-ancestry populations. However, more population diversity is needed to better understand the AD genetic complexity across populations.

L'épilepsie est associée à des troubles cognitifs, des difficultés affectives et des troubles de la personnalité. Évaluer la perception de l'épilepsie dans le milieu enseignant dans la ville de Bouar. Étude transversale menée de novembre 2019 à avril 2020, chez les enseignants exerçant dans les établissements scolaires publics et privés, de la maternel jusqu'au lycée dans la ville de Bouar. L'âge moyen était de 38,5 ans. La tranche d'âge de 20 à 29 ans était la plus représentée. Le principal facteur déclenchant l'épilepsie était l'arrêt du traitement (33,3 %). Parmi les répondants, 70,4 % étaient d'avis que l'épilepsie est curable. Les élèves épileptiques seraient victimes de stigmatisation (61 %). Les conséquences de cette affection étaient le retard scolaire (28 %) et l'abandon scolaire (19 %). La tranche d'âge de 20 à 39 ans était la plus représentée. Ce résultat corrobore les données des études réalisées en Afrique. La principale source d'information provenait des causeries (72 %). Ce résultat est superposable aux précédentes études réalisées en Centrafrique dans la population générale. La majorité des enseignants connaissent l'épilepsie. Mais, ces connaissances restent erronées et basées sur les préjugés. Ceci a un impact négatif sur le devenir des élèves épileptiques.

Introduction: The stroke is a real public health problem due to its frequency, its severity, its residual physical and cognitive handicap and its financial cost for society.Goal of the Study: To contribute to the knowledge of these conditions in neurological practice in the Central African Republic.Methodology: Analytical cross-sectional study which took place over a period of 4 months from June 1 to September 30, 2020, in subjects aged 55 and over hospitalized in the Neurology department of the Friendship Sino University Hospital.Central African woman for a stroke with a complete file.Results: During the study, 118 patients were hospitalized in the department, including 24 cases of stroke, for a hospital frequency of 20.33%.The average age was 67.1 years old and the male/female sex ratio was 1.6.Motor deficit and language disorder were the main reasons for consultation (100%).Hypertension was the main risk factor (91.7%).Stroke was the most predominant type of stroke (54.8%).Most of our patients (58.3%) were admitted to healthcare facilities before 6 a.m.The lethality was 25%.There was a statistically significant association between the severity of hypertension and the type of stroke as well as the patient's condition at discharge.The NIHSS score and the KARNOFSKY score were significantly related to the patient's condition at discharge.All the discharged patients presented with sequelae such as hemiparesis (75%) and dysarthria (45.8%).Conclusion: Stroke is a serious, disabling pathology that is increasingly common with the aging of the population.The creation of a neurovascular unit and a rehabilitation unit could improve the prognosis and course of stroke in our elderly patients.

PURPOSE:Neurology is one of Africa's central and noble specialties due to the frequency of its related diseases. Through this study we: -1-described the status of neurologists in Africa in terms of numbers,-2-listed the reasons and discussed how to increase their number, and how to get the most benefit of them in healthcare coverage.METHODS:The distribution and number of neurologists in the African continent was acquired from many participants in different African countries using a survey sent between March 2020 and August 2020 by email. Further, data from the World health organization on the number of neurologists was added for the countries, from which we didn't receive answers by the survey.RESULTS:Surveys' answers were received from representatives of 50 (92%) of the 54 African nations. Authors suggest a ranking into four levels according to the number of neurologists per nation. Level A [more than 201 neurologists per country] included 2 nations. Level B [31 to 200 neurologists per country] included six nations. Level C [1 to 30 neurologists per country] including the majority of African countries (36 nations). Level D includes 10 nations without any neurologists.CONCLUSION:The need for reliable and competent neurologists with a sufficient number is considered as a crucial element to enhance the care of neurological diseases in Africa. For this, all African countries should establish new centers of excellence in neurology, by developing good south-south collaboration with supports from governmental and non-governmental institutions.

Epilepsy is a major public health problem in developing countries where eighty percent (80%) of people with epilepsy (PWE) live. Stigma has psychological consequences as well as serious repercussions on patients' quality of life. This study assesses the perception of health professionals in Africa regarding the stigmatization of PWE.METHODOLOGY:This is a multicenter descriptive, cross-sectional study, from 1st August 2020 to 1st September 2021. Medical practitioners from African countries involved in the management of epilepsy and who agreed to fill out forms were included in the study. Sampling was nonrandom and based on respondent choice. The data were analyzed using the EPI INFO 7 software.RESULTS:A total of two hundred and twenty-nine (229) health workers from twenty-six (26) African countries participated in this survey. 24.89% of the respondents were specialists and 46.72% were neurologists. Ninety-one percent (91%) of practitioners felt that PWE were stigmatised. The main forms of stigma were isolation (68.56%), celibacy (60.70%), unemployment (53.28%), divorce (44.54%) and exclusion (37.99%)%). Community, school and family were recognized as the main places of stigmatization. The fight against this stigma was carried out mainly in hospitals and in isolation in 58.4% and 55.8% of cases, respectively. Only 0.4% of practitioners opted for mass awareness.CONCLUSION:PWE are victims of various forms of stigmatization, particularly in community settings. Measures aimed at raising awareness of the public are essential to reduce this stigma and improve patients' quality of life.

Stroke is a very common neurological condition that causes permanent disability in half of the cases, at least in sub-Saharan Africa. They represent the second most common cause of death in Africa. Objective of this study was to evaluate the prognostic value of the intake period of patients suffering from these conditions on the survival time of one month of hospitalization in hospitals in Bangui. We conducted a prospective study cross prognostic kind in the neurology departments, internal medicine and intensive care units of two large central hospitals from February to August 2017. Subject recruitment was complete with a made questionnaire based on the modified one of the World Health Organization on neurological disorders. A total of 154 patients were included, with a mean age of 63.15 years ± 10.98 and extremes ranging from 38 to 91 years. A male predominance was noted (60%) with a sex ratio (M/F) of 1.5. For 76 subjects (49.35%), care was taken with a hospital admission period of less than or equal to one day, while for 78 other 78 (50.65%) the admission period was higher to one day. Average admission time patients caught early was 1.00 day and the upper limit intake to one day was 4.59 ± 2.33 days with a statistically significant difference (p < 0.0001). Median admission delay for patients treated late was 4 days. Pre-hospital and hospital determinants by admission delay are presented in Table 1. The survival time was better in the group of patients who were treated early (p = 0.0039). This study shows the negative impact of late management on the survival time of patients.

Background The term Nodding Syndrome (NS) refers to an atypical and severe form of childhood epilepsy characterized by a repetitive head nodding (HN). The disease has been for a long time limited to East Africa, and the cause is still unknown. The objective of this study was to confirm the existence of NS cases in Central African Republic (CAR). Methodology/Principal findings This was a cross-sectional descriptive study in the general population. The identification of NS cases was conducted through a door-to-door survey in a village near Bangui along the Ubangui River. Based on Winkler’s 2008 and the World Health Organization (WHO)’s 2012 classifications, the confirmation of cases was done by a neurologist who also performed the electroencephalograms. No laboratory tests were done during this investigation. Treatment was offered to all patients. A total of 6,175 individuals was surveyed in 799 households. After reviewing the cases, we identified 5 NS cases in girls aged between 8 and 16. The age of onset of the seizures was between 5 and 12 years of age. Two cases were classified as "HN plus" according to Winkler’s 2008 classification. Four NS cases were classified as probable and one as confirmed according to the WHO’s 2012 classification. Three of them presented with developmental delay and cognitive decline, and one had an abnormally low height-for-age z-score. Electroencephalographic abnormalities were found in four patients. Conclusions/Significance Nodding Syndrome cases were described in CAR for the first time. Despite certain peculiarities, these cases are similar to those described elsewhere. Given that only a small part of the affected area was investigated, the study area along the Ubangui River needs to be expanded in order to investigate the association between Onchocerca volvulus and NS and also evaluate the real burden of NS in CAR.

BACKGROUND:Visual impairment (VI) and determinants of poor cardiovascular health are very common in Sub-Saharan Africa. However, we do not know whether these determinants are associated with VI among older adults in this region. This study aimed at investigating the association between the determinants of poor cardiovascular health and near VI among older adults living in Congo.METHODS:Participants were Congolese adults aged 65 or older included in Epidemiology of Dementia in Central Africa-Follow-up population-based cohort. Near VI was defined as visual acuity less than 20/40 measured at 30 cm. Associations between determinants of poor cardiovascular health collected at baseline and near visual acuity measured at first follow-up were investigated using multivariable logistic regression models.RESULTS:Among the 549 participants included, 378 (68.8%; 95% confidence interval [CI]: 64.9%-72.7%]) had near VI. Of the determinants of poor cardiovascular health explored, we found that having high body mass index of at least 25 kg/m2 (odds ratio [OR] = 2.15; 95% CI: 1.25-3.68), diabetes (OR = 2.12; 95% CI: 1.06-4.25) and hypertension (OR = 1.65; 95% CI: 1.02-2.64) were independently associated with near VI.CONCLUSIONS:Several determinants of poor cardiovascular health were associated with near VI in this population. This study suggests that promoting good cardiovascular health could represent a target for VI prevention among older adults.

Introduction: Very little is known about the impact of vision impairment (VI) on physical health in late-life in sub-Saharan Africa populations, whereas many older people experience it. We investigated the association between self-reported VI and frailty in Central African older people with low cognitive performance. Methods: It was cross-sectional analysis of data from the Epidemiology of Dementia in Central Africa (EPIDEMCA) population-based study. After screening for cognitive impairment, older people with low cognitive performance were selected. Frailty was assessed using the Study of Osteoporotic Fracture index. Participants who met one of the 3 parameters assessed (unintentional weight loss, inability to do 5 chair stands, and low energy level) were considered as pre-frail, and those who met 2 or more parameters were considered as frail. VI was self-reported. Associations were investigated using multinomial logistic regression models. Results: Out of 2,002 older people enrolled in EPIDEMCA, 775 (38.7%) had low cognitive performance on the screening test. Of them, 514 participants (sex ratio: 0.25) had available data on VI and frailty and were included in the analyses. In total, 360 (70%) self-reported VI. Prevalence of frailty was estimated at 64.9% [95% confidence interval: 60.9%–69.1%] and 23.7% [95% CI: 20.1%–27.4%] for pre-frailty. After full adjustment, self-reported VI was associated with frailty (adjusted odds ratio = 2.2; 95% CI: 1.1–4.3) but not with pre-frailty (adjusted odds ratio = 1.8; 95% CI: 0.9–3.7). Conclusion: In Central African older people with low cognitive performance, those who self-reported VI were more likely to experience frailty. Our findings suggest that greater attention should be devoted to VI among this vulnerable population in order to identify early frailty onset and provide adequate care management.