Profile of multiple system atrophy in Moroccan patients attending a movement disorders outpatient clinic in Rabat university hospital

Introduction. - Multiple system atrophy (MSA) is a sporadic and rapidly progressive neuro-degenerative disorder of poor prognosis, characterised clinically by any combination of parkinsonian, autonomic, cerebellar, or pyramidal signs. We report our experience in movement disorders consultation concerning the clinical presentation and the course of MSA in Moroccan patients. Methods. - A retrospective review of the medical records of 17 patients with diagnosis of MSA seen in our outpatient clinic from January 2007 to December 2010. Results. - In our 17 patients, 76.5% were men and the mean age of onset was 52 +/- 9 years. MSA-P was the major clinical phenotype (82.4%). Eleven patients (64.7%) were classified as having probable MSA and six patients (35.3%) as possible MSA. Dysautonomic features were detected in all patients; urinary symptoms were found in 76.5% of cases and orthostatic hypotension in 64.7%. Treatment regimen included L-Dopa with a mean daily dose of 621.4 +/- 346.8 mg/day and symptomatic treatment of dysautonomia. The mean duration of disease evolution was of 4.7 +/- 1.9 years. Discussion. - Our results show a male predominance and an early age of disease onset. MSA-P was the predominant subtype. Our results are similar to the European MSA series. Conclusion. - Multicentre studies are needed to better characterise MSA in Morocco given the rarity of this disease. (C) 2012 Elsevier Masson SAS. All rights reserved.