Diagnostic and therapeutic challenges of demyelinating diseases of the central nervous system: about a series of eight suspected cases of neuromyelitis optica spectrum disorders and anti-MOG antibody-associated disease in Kinshasa

Introduction: Neuromyelitis spectrum disorders and anti-oligodendrocyte myelin glycoprotein spectrum disease are 2 autoimmune, inflammatory and demyelinating diseases of the central nervous system (CNS) whose diagnosis in the Democratic Republic of Congo (DRC) poses various problems delaying on the one hand the management of relapses and on the other hand the initiation of disease-modifying treatment. Methodology: This is a report of cases with a suspected clinical presentation of CNS demyelinating disease. Results: A total of 8 patients were identified with a mean age of 31.25 years with extremes of 23 to 46 years. As a clinical picture, 62.5% had myelitis; in 87.5% of patients, the initial diagnosis was other than that of a demyelinating CNS disease and 75% had performed a spinal marrow MRI (Magnetic Resonance Imaging) and in no patient had the search for specific antibodies been performed. Only one patient had benefited from a disease-modifying treatment based on Rituximab. Conclusion: The difficulties in diagnosing and managing CNS demyelinating diseases in the DRC are linked on the one hand to the health professional, on the other hand to the lack of diagnostic tools and the lack of financial means of patients.