Multiple Sclerosis Epidemiology in East Asia, South East Asia and South Asia: A Systematic Review.

BACKGROUND: Multiple sclerosis (MS) is one of the most common chronic immune-mediated diseases of the human central nervous system and an important cause of non-traumatic neurologic disability among young population in several countries. Recent reports from East Asia, South East Asia and South Asia have proposed a low to moderate prevalence of MS in these countries. METHODS: A literature review search was carried out in December 2014 in Medline, Embase, Scopus and Cochrane library to recover original population-based studies on MS epidemiology in East Asia, South East Asia and South Asia countries published between January 1, 1950 and December 30, 2014. We intended search strategies using the key words: multiple sclerosis, prevalence, incidence and epidemiology. Based on our inclusion criteria, 68 epidemiologic studies were included in this systematic review. RESULTS: The most extensively used diagnostic criteria in the studies were McDonald's criteria. Most studies were performed in a multi-center hospital setting. The female to male ratio varied and ranged from 0.7 in India to 9.0 in China. The mean age at disease onset ranged from the lowest age of 25.3 in Iran to the highest age of 46.4 in China. MS prevalence ranged from 0.77 in 100,000 populations in Hong Kong (1999) to 85.80 in 100,000 in Iran (2013). CONCLUSIONS: Advances in MS registries around the globe allow nationwide population-based studies and will allow worldly comparisons between the prevalence and incidence in different regions that are provided to monitor estimation.

Behavioral Neurology of Multiple Sclerosis and Autoimmune Encephalopathies.

Multiple sclerosis (MS) is the most common nontraumatic cause of physical disability in young adults. Cognitive and neuropsychiatric problems are common in this disease independent of motor disability. Such problems especially in mild cases are ignored by physicians, although they may have a major impact on quality of life. Neurobehavioral changes may affect the adherence to treatment and worsen the ultimate prognosis. Although many studies have been performed in this regard, it seems that combining cognitive evaluations with other outcome measures in MS will enhance the understanding of neurobehavioral changes in MS.