PREVALENCE, FORMES CLINIQUES, EVOLUTION, ET TRAITEMENT DE LA SCLEROSE EN PLAQUES DANS LA REGION DE TLEMCEN

Abstract

Introduction Multiple sclerosis is a chronic and invalidating neurological affection,it s the first no traumatic cause of handicap in young adult.Algeria is considered as a region of low risk ,few epidemiological studies on MS were realized.It’s the first study made in the region of Tlemcen.It is a city situated in the northwest of Algeria,in 520km from algiers and 40 km from the morroccan border.It ‘s latitude is 34°53 north.his population was estimated as 140 158 inhabitants in 2008(national office of statistics). Patients and methods : It is a transversal descriptive study,that concerned all the patient living in th region of Tlemcen followed in the MS consultation of the teaching hospital of Tlemcen .The diagnosis was put according to the criteria of Mc Donald (2005-2010).All the patients have beneficed from a cerebral and spine MRI,as well as immunological analysis in blood and cerebrospinal fluid.Visual evoked potential was realized in almost totality of the cases .The handicap was appreciated by the expanded disability status scale(EDSS). Results: Among 2002 patients ,38 lived in the municipality of Tlemcen,on November 30th ,the prevalence of MS was estimated to be 26,3/100 000 inhabitant.The females outnumbered males with a female to male ratio of 1,84 .The mean age of onset of MS was 29.23 ± 7.55 years , women began their disease earlier than men. A positive family history of MS was reported by 9,2%.The monosymptomatic onset was the most frequent (80,7%).The most frequent symptoms at disease onset were motor (42,2%), sensory(17,9%) and optic neuritis(19,6%).The majority of patients presented with remittent –reccurent MS (76,8%), followed by secondary progressive MS.The average deadline to reach the EDSS 6 is of 10 years .Male gender , progressive onset ,high number of relapses in the first five years were predictive factors of premature evolution towards the handicap.Polysymptomatic onset ,high number of relapses in the first two years were factors of bad forecast.The treatment by interferon is generally tolerated well. Conclusion : This study classifies the municipality of Tlemcen in a zone at average risk with a prevalence rate of 26,3/100 000 inhabitant.Any epidemiological study was made until this day in the region .Other studies turn out to be necessary in other region of Algeria in particular in th south.The creation of a national register of MS is at the present essential for a better analysis of epidemiological data. Keywords : multiple sclerosis , prevalence ,clinical forms ,evolution ,predictive factors , treatment , Tlemcen, epidemiology