Objective: The objective of our research was to describe the epidemiological, therapeutic features and effectiveness of deep brain stimulation in operated patients. To cite the main limits of Deep brain stimulation (DBS) for Parkinson’s disease (PD) in south of Morocco.

Background: DBS is a recognized technique for the treatment of several movement disorders, especially advanced forms of PD. bilateral high-frequency stimulation of the subthalamic nucleus (STN) is considered the method of choice for treating PD. This technique improves the quality of life of patients, reduces motor complications and allows a substantial reduction in drug treatments.

Method: Standard DBS surgery targeting bilateral STN was performed in 24 patients from its start in 2017 until December 2020 at the neurology department Mohamed VI University Hospital of Marrakech. We prospectively followed and evaluated the effects of DBS on gait and disease severity using UPDRS score.

Results: The average age of our patients was 54 years with extreme ages between 39 and 67 years. The sex ratio (M / F) was 1,4. More than 90% of the patients received two treatments including dopa-therapy (between 625 mg to 1750 mg daily). Mean sensitivity to L dopa in our operated patients was 61. The main indication for STN-DBS was disabling motor fluctuations in 21 patients: ON / OFF phenomenon in 20 patients, end-dose OFF in 12 patients, early morning akinesia in 5 patients, freezing off in 2 patients. At the initial programming the average of the amplitude to the left and right was 2.25 (1.5 to 3) with 130 Hz frequency. After 2 years of follow-up, the reduction of the UPDRS was more than 70% in 19 of the stimulated patients, between 50 – 60% in 5 patients. 21 patients had a reduction in the dopa-therapy doses ranging from 40% to 54%. 60% of our patients were satisfied, two cases of repeated superficial infections, worsening of axial signs in 10 patients.

Conclusion: Through the analysis of our 4 years young experience many challenges were faced. First of all PD is not taken as a public health priority. Secondly the overpriced of DBS equipment and PD medication compared to a poor social health insurance and finally lack of specialized movement disorders centers.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/deep-brain-stimulation-in-parkinsons-disease-challenges-of-a-young-experience-in-southern-morocco/