A Tetra Paresis Revealing Multiple Sclerosis: About a Case and Review of the Literature

Multiple sclerosis (MS) is very little described in tropical environments. It represents the leading cause of non-traumatic neurological disability in young subjects. We report the case of a patient with MS, 31 years old with no particular medical history, progressively presented weakness of the 4 limbs followed by lumbar pain which regressed after 2 months under the effect of symptomatic treatment with corticosteroids. Three months later, he presented with dysarthria and gait disturbance. The neurological examination revealed a bilateral pyramidal syndrome and a kinetic-static cerebellar syndrome. Brain magnetic resonance imaging (MRI) has objectified bihemispheric hypersignals predominantly periventricular, internal capsule, lenticular nucleus, thalamus, frontal and parietal lobe in axial section on flair sequences. Biology showed inflammatory syndrome. The patient received boluses of methylprednisolone for one week. The clinical evolution was favorable with an EDSS score of 3 at discharge. We report a case of multiple sclerosis in the republic of guinea. The evolutionary mode was in favor of a second push of a relapsing form. The clinical evolution of our patient was favorable under corticosteroid therapy and the patient presented an EDSS score of 6 at discharge. MS is very little described in Guinea. The diagnosis is based on clinical and paraclinical arguments; corticosteroid therapy was the treatment of first choice in our context.