Objective: To determine the frequency and clinical features of PD at the neurology department of Point G Teaching Hospital.

Background: PD results from loss of dopaminergic neurons in the nigrostriatal pathway. It occurs throughout the world, increases exponentially with age, varies by geographic regions, and is higher among men than women. It affects all ethnic groups and both sexes. Motor signs comprise bradykinesia, rigidity, resting tremor, and postural instability. Non-motor symptoms include but are not limited to dementia, executive dysfunction, sleep disturbances, and autonomic dysfunction. PD can be subdivided into tremor-dominant, akinetic-rigid and the mixed type. The cause of PD remains poorly understood with a complex interplay between genetic and environmental factors. After increasing age, a family history of PD remains the most important risk factor for developing PD with the discovery of inherited forms of PD. In Mali, PD is underestimated and there are few reports about it.

Methods: From January 2014 to November 2015, we recorded all cases of PD using inpatient and outpatient visit data. Patients with clinical features of bradykinesia, tremor, rigidity or postural instability, with responsiveness to dopaminergic therapy as a supportive phenomenon were tested with the UPDRS evaluation tools. Demographic and clinical data were analyzed using Epi-info computer package.

Results: Among the 9474 patients seen at the neurology department during the study period, 82 patients (0.87%) had PD. There was a male preponderance, 59.7% for male and 40.3% for female. Patients aged 61-80 years of age were the most affected by the disease with 63.4% (52/82). The frequency of young onset of PD (less than 50 years) was 13.4% (11/82). A positive family history of PD was present in 34.1% (28/82). PD sub type was tremor-dominant in 21 (25.6%), mixed in 48 (58.5%) and akinetic-rigid 13 (15.8%). Executive dysfunction occurred in 8 cases (9.75%). Sleep disorders were observed in 28 cases (34.14%). 6 patients had autonomic dysfunction (7.31%).

Conclusions: PD is frequent in Mali and the clinical profile is similar to that reported in other populations, but is characterized by a high proportion of mixed type and a positive family history of PD as it has been reported in other Sub-Saharan countries. More genetic studies are needed to examine inherited forms of PD among Malians with positive family history of PD.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/clinical-profile-of-parkinsons-disease-at-the-neurology-department-of-point-g-teaching-hospital/