Inflammatory diseases of the central nervous system in adults at the Brazzaville University Hospital Center, Congo

Inflammatory diseases (IDs) of the central nervous system (CNS) constitute a heterogeneous group of immune-mediated disorders that can lead to neurological disability. Data on these diseases remain limited in sub-Saharan Africa. To describe the epidemiological, clinical, and paraclinical aspects of CNS IDs in adults in Brazzaville, Congo; to describe the therapeutic strategies implemented; to evaluate the outcome of pathological entities at hospital discharge. This was a retrospective descriptive study carried out in the neurology department of the Brazzaville University Hospital Center. The study period was from January 2018 to December 2023. The study included patients aged 18 years or older. The diagnosis of each entity of CNS IDs was based on clinical data, MRI findings, cerebrospinal fluid analysis, and available laboratory investigations, according to international consensus criteria for this disease. At hospital discharge, the documented clinical outcome was as follows: improvement, stabilization, or deterioration. Of the 44 patients included in the study, 29 (65.9%) were women. The average age of the patients was 35.0 ± 9.9 years. The most common diagnostic categories were idiopathic acute transverse myelitis ( n = 10), unclassified acute inflammatory medullary syndrome ( n = 10), neuromyelitis optica spectrum disorders ( n = 5), and isolated optic neuritis ( n = 5). Intravenous corticosteroid therapy with methylprednisolone was administered to all patients, followed by oral prednisolone. Maintenance immunosuppressive therapy was initiated in 5 (11.4%) patients. At hospital discharge, three types of outcomes for CNS IDs were recorded: clinical improvement ( n = 29; 65.9%); stabilization ( n = 10; 22.7%), and deterioration ( n = 5; 11.4%). The spectrum of CNS IDs in adults in Brazzaville is broad. In our cohort, IDs of the CNS are predominantly characterized by spinal cord syndromes. The lack of specific biomarkers has limited the accuracy of the diagnosis. Overall, the immunosuppressive therapy used has led to a clinical improvement in most patients at hospital discharge.