Category: Surgical Therapy: Parkinson's Disease
Objective: The objective of our study is to specify the selection criteria necessary to benefit from deep brain stimulation, to study clinical progress and improvement after surgery, and to describe the complications that have arisen and their management.
Background: Deep brain stimulation (DBS) is a recognized treatment for Parkinson’s disease. However, it is still a long, delicate and potentially surgical procedure, which requires careful selection of candidates in order to have the best results and reduce the risk of complications.
Method: This is a retrospective study on the medical file of 10 patients collected at the neurology department of the Mohammed VI Oujda University Hospital. All patients have the clinical characteristics, evolutionary and response to the levodopa typical of Parkinson’s disease and are insufficiently controlled by the pharmacological treatment available, hence the indication of DBS.
Results: Our serie include four women and six men. The average age of our patients is 59.8 years (48–68). The average duration of the disease is 17 years (08–27 years). The selection of candidates is based on several criteria: comorbidities and operative risk, the UPDRS score, the patient’s psychiatric and cognitive evaluation, the patient’s expectations of surgery and normality of brain MRI. Our patients were evaluated with the same protocol, before and after surgery. The evaluation of the preoperative patients was carried out with both “OFF” and “ON” drugs and included the evaluation of the ‘UPDRS, the stages of Hoehn and Yahr and the scale of Schwab and England. The comparison of the pre- and postoperative clinical scores showed a significant improvement after surgery. There was a significant improvement in Hoehn and Yahr stages in all of our patients. A comparison of the preoperative “OFF” medication and postoperative “OFF” medication / “ON” Stimulation states showed a 72% improvement in the UPDRS motor score. However, 4 patients presented complications: post-traumatic hematoma next to the stimulation unit, skin fistula next to the cervical passage of the stimulation electrode, infection, behavioral disorders of which only one patient was taken up surgically.
Conclusion: The effectiveness of DBS is no longer needs to be proven, but the non-negligible frequency of adverse events should encourage us to improve the procedures and establish adequate management.
To cite this abstract in AMA style:F. Aziouaz, T. Dellal, Y. Mebrouk. Deep brain stimulation in Parkinson’s disease: Selection criteria, post-surgery improvement and complications [abstract]. Mov Disord. 2020; 35 (suppl 1). https://www.mdsabstracts.org/abstract/deep-brain-stimulation-in-parkinsons-disease-selection-criteria-post-surgery-improvement-and-complications/. Accessed December 7, 2023.
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MDS Abstracts - https://www.mdsabstracts.org/abstract/deep-brain-stimulation-in-parkinsons-disease-selection-criteria-post-surgery-improvement-and-complications/