Fréquence et profil clinique de la maladie de Parkinson et des autres syndromes Parkinsoniens vus au service de neurologie de l'hôpital Befelatanana Antananarivo

INTRODUCTION: Currently we have no precise data on the parkinsonian syndromes in Madagascar. This study aims to collect data on these diseases and to describe the frequency and the clinical profile of parkinsonian syndromes in our Department of Neurology. METHODS: We conducted a retrospective and descriptive study in the Department of Neurology, in Befelatanana from January 2014 to June 2018. The demographic and clinical data of patients diagnosed as having a parkinsonian syndrome were collected. We assessed data rates and characteristics and then we compared patients with idiopathic Parkinson's disease and patients with other parkinsonian syndromes. Data were processed using R. software. RESULTS: The study included 104 of 3528 patients, seen in our Department. Among the patients with parkinsonian syndrome, 67(64.42%) had idiopathic Parkinson's disease (PD) and 37 (35.47%) another parkinsonian syndrome. The average interval between the onset of the disease and the consultation or the hospitalization in the Department was 2.5 years. For MP, the median age at onset was 58.5 [23; 80] years, the median age at diagnosis was 62 [28; 83] years and the sex ratio were 1.97. The median Hoehn and Yahr score were 2.0. Tremor-dominant Parkinson's disease was found in 24 (35.42%) of cases, a mixed phenotype was found in 28 (41.71%) of cases while akineto-rigid Parkinson's disease was found in 15 (22.38%) of cases. The other parkinsonian syndromes ocuurred in 27 (72.97%) men, with a median age at onset of 57.5 [26; 83] years, a median age at diagnosis of 59.3 [26; 83] years. Etiologies were dominated by Multiple System Atrophy 17/37 (46.64%). Patients with other parkinsonian syndromes had several cognitive disorders (p=0,0306) and MPs were more sensitive to dopamine (p=0.006). CONCLUSION: The patients with idiopathic parkinsonian syndrome had features different from those of patients with parkinsonism. There was a diagnostic delay as in other developing countries.