Objective: To highlight our Experience in DBS for Parkinson’s in Egypt, to our knowledge we are the first team for DBS in Egypt, and so far the team with the largest number of operated PD patients, in addition to following up and programming of many patients operated elsewhere. So we thought that it would be beneficial to publish and document our work.

Background: DBS became and effective and established treatment for selected cases of complicated  Parkinson’s patients, since its first introduction by Benabied in the late 1980s and early 1990s. STN is the most popular target for implantation in PD patients, however Gpi is the target in selected cases of Parkinson’s. Surgery should be considered when the patients’ symptoms are severe enough to justify the risk for operation. Complimentary team between the Neurologists and the Neurosurgeons is mandatory, Good candidate selection is the most important factor in the success of DBS surgery along with optimum electrode placement and experienced follow up and programming sessions for those patients along with expert medication adjustment.

Method: 10 Parkinson’s patients were included. All patients were selected according to CAPSIT-PD criteria, Base line preoperative scales were : UPDRS III in off , and on condition, MoCA test, PD Q 39 test, Non- Motor symptom assessment scale for Parkinson’s disease. UPDRS III, PD-Q 39 and Non-Motor symptom assessment scale for Parkinson’s disease were repeated postoperative after 6 months and one year.

Results: Nine patients showed marked improvement in UPDRS III scale, PD Q 39, Non- Motor symptom assessment scale for Parkinson’s with statistical significant difference between preoperative and post-operative scales at 6 month and one year respectively. Three patients stop completely any levodopa or dopaminergic medications, and the others markedly reduced medications dosage. Regarding the Non Motor scale improvement were mainly and respectively in urinary domain, fatigue and sleep domain, miscellaneous domain, and gastrointestinal domain. No complications had occurred in any of our patients.

Conclusion: DBS for Parkinson’s is doable in Egypt, and an effective modality of treatment for PD patients, it needs multidisciplinary team’s management, it is an effective treatment for motor and non -motor complications and leads to improvement of the quality of life of patients and their care givers.

References: 1- Anna Castrioto, Eugénie Lhommée, Elena Moro and Paul Krack :Mood and behavioural effects of subthalamic stimulation in Parkinson’s disease, Lancet Neurol 2014; 13: 287–305. 2- Anthony E. Lang and Hakan Widner, Deep Brain Stimulation for Parkinson’s Disease: Patient Selection and Evaluation: Movement Disorders journal, Vol. 17, Suppl. 3, 2002, pp. S94–S101. 3- Anthony E. Lang, Jean-Luc Houeto, and Paul Krack et al., :Deep Brain Stimulation: Preoperative Issues, Movement Disorders Vol. 21, Suppl. 14, 2006, pp. S171–S196. 4- Marina Picillo , Andres M. Lozano , Nancy Kou , Programming Deep Brain Stimulation for Parkinson’s Disease:The Toronto Western Hospital Algorithms, Brain Stimulation, 2016. 5- Robert N. Holdefer, Bernard A. Cohen, and Karl A. Greene :Intraoperative Local Field Recording for Deep Brain Stimulation in Parkinson’s Disease and Essential Tremor, Movement Disorders, Vol. 25, No. 13, 2010, pp. 2067–2075. N.B: All preoperative and postoperative videos are available

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MDS Abstracts - https://www.mdsabstracts.org/abstract/dbs-in-parkinsons-disease-experience-from-egypt/