Motor and non-motor features of Parkinson's disease.

Background: Parkinson's disease (PD) is a common neurodegenerative brain disease in developed countries where population of the elderly is high. PD is increasingly being documented in developing countries where there are rapid demographic changes. Motor features of PD have been documented in Africans in previous studies. However non-motor features such as depression and sleep disturbance have not been well documented.

Objective: To study the motor and non-motor features of idiopathic Parkinson's disease in Tanzania.

Design: A descriptive consecutive referral of patients to the national tertiary care hospital.

Setting: Neurology clinic at Muhimbili National Hospital a major teaching and national referral hospital.

Results: Forty two of 1,908 (2.2%) new referralpatients over four years of study satisfied the criteria for idiopathic PD. Of these 25 (59.5%) were males and 17 females. There was no significant difference between sex, in demographic and clinical features. Nevertheless females tended to be older; and the majority of whom were housewives. Three male patients were in advanced stage five and six or UPDRS above 61/108. Thirty nine (92.8%) patients completed BDI and none of these had a BDI score of more than ten. Insomnia was reported in 14(33%) of patients. There was no significant difference between age, sex, clinical stage or UPDRS score. However 12 (28.6%) of 42 patients had been noted to have at least one sleep behaviour disorder and all had mild to moderate disease at stages one to three or UPDRS score of 60/108 or less.

Conclusion: Idiopathic Parkinson's disease is increasingly being seen in Tanzania due to the ageing population. Majority of patients in this series were in early stage of disease. Depression was conspicuously absent. However sleep behaviour disorder, which is potentially harmful to the patient, bed partners and requires different management, was a common feature that was elicited by direct enquiry in patients with Parkinson's disease.