Multiple Sclerosis in a Chronic Smoker: A Case and Literature Review at the National General Referral Hospital of N’Djamena (Chad)

Introduction: Multiple sclerosis is characterized by demyelination of the white matter of the central nervous system.Multiple sclerosis (MS) manifests clinically by subacute encephalic and/or medullary pictures.In black Africa; a few cases have been reported in Senegal, Kenya and Ivory Coast.In Chad, no study has been carried out to date on Multiple sclerosis (MS).Observation: Mr. AX, 35 years old, a trader with a history of chronic smoking, was admitted on March 13, 2023, for progressive left hemiplegia.The clinical picture began a few days earlier with paresthesias of the right upper limb.These sensory disturbances were followed by rapidly progressive left hemiplegia.She also reported recent blurred vision.The brain scan was strictly normal.During hospitalization, she presented with monoplegia of the right upper limb.Treatment with methylprednisolone at a rate of 1 g of solumedrol in 500 ml of glucose serum was instituted once a day for 5 days.The patient was then urgently evacuated to Senegal.A cerebral and spinal cord resonance imaging (MRI) was performed.It showed several hypersignals at the cerebral level, suggesting Multiple sclerosis (MS).At the medullary level: confluent hyper signals of the MS type.Discussion: MS is considered rare in Africa, particularly in Central Africa.Several factors tend to explain this: The existence of a North-South gradient: in fact, the further one moves away from the equator, the more the prevalence of the condition tends to increase, while it is low in neighboring regions; in tropical and intertropical countries, the prevalence of MS varies between 5.0 and 6.5/100,000 inhabitants.Recent studies, notably those of 2021 and 2024, confirm this link.It has been