Objective: Study the various clinical, electrophysiological and therapeutic parameters of operated patients.
Evaluate the effectiveness of deep brain stimulation of STN in Parkinson’s disease.

Background: Treatment with high-frequency bilateral deep brain stimulation of the subthalamic nucleus is considered the method of choice for treating severe and advanced forms of Parkinson’s disease. This technique significantly improves the quality of life of patients, parkinsonian disability, motor complications and allows a substantial reduction in drug treatments.

Method: This is a retro spective study on 30 patients with Parkinson’s disease who received a deep brain stimulation in the neurology department of university hospital Hassan II of Fez.

Results: The average age of our patients was 52 years with extreme ages between 34 and 68 years. The sex ratio (M / F) was 1,3. For the duration of the development of Parkinson’s disease : 63 % of patients have evolved for more than 10 years , 20% had a development period between 8 and 10 years and 17% between 3 and 7 years . The average sensitivity to L dopa in our operated patients was 66,34 . Note that 33% of patients had a sensitivity to L dopa greater than 70%. The average dose of dopa therapy taken by the patients was 1066.33 mg daily with extremes between 450 mg and 2250 mg. At the initial programming the average of the amplitude to the left and right was 1.88. The reduction of the UPDRS was more than 60% in 23 of the stimulated patients, between 40 – 59% in 7 patients.
Dyskinesia was present in 28 patients, motor fluctuations in 29 patients: ON / OFF phenomenon in 10 patients, end-dose OFF in 18 patients, early morning akinesia in 8 patients, freezing off in 3 patients.
14 patients had a reduction in the dose of L dopa after surgery greater than 40%, 2 patients kept the same initial dose. For postoperative complications, there was one case of subdural hematoma and one case of neck pain, for hardware-related complications: there was one case of electrode fracture and one case of infection.

Conclusion: Deep brain stimulation has revolutionized the management of  Parkinson’s disease in the advanced stages of course if the indications are adequate with a good selection of  the patients.

References: 1- F.CAIRE, PH.DEROST, J.COSTE, SUBTHALAMIC STIMULATION IN SEVERE PARKINSON’S DISEASE, Study of the location of effective contacts, Neurosurgery, 2006,52 n ° 1, 15-25 2- Mathers J, et al. BMJ Open Patients’ experiences of deep brain stimulation for Parkinson’s disease: a qualitative systematic review and synthesis 2016; 6: e011525. doi: 10.1136 / bmjopen-2016-011525 3- A. Machado, Al Rezai, MD, H. Kopell, Deep Brain Stimulation for Parkinson’s Disease: Surgical Technique and Perioperative Management, Movement Disorders Vol. 21, Suppl. 14, 2006, pp. S247 – S258, Discorder Society Movement, 2006.

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