RESUMO
OBJECTIVE: Investigate the incidence of multiple sclerosis during 1953-2013 and estimate the prevalence rate of MS on 1 January 2003 and 2013 in Hordaland County, Western Norway. METHODS: All patients with onset of disease in Hordaland 1953-2013 were identified in files from previous studies until 2003 and from patient records at the departments of Neurology, Haukeland University Hospital and Haugesund Hospital during 2003-2013. 1558 patients were assessed and 1402 of these were included, of whom 1035 were alive and living in Hordaland at prevalence day 1 January 2013. Annual incidence rates were calculated for 1953-2013. RESULTS: On 1 January 2003, the crude prevalence rate was 191/100â 000 population and on 1 January 2013, the crude prevalence rate was 211.4 (95% CI 198.3 to 224.2) per 100â 000; 270.9 (95% CI 250.6 to 292.3) for women and 151.8 (95% CI 136.8 to 167.9) for men. Prevalence peaked at ages 55-59â years for women and 60-64â years for men. The annual incidence rate increased from 1.9 (95% CI 1.2 to 2.6) per 100â 000 during 1953-1957 to 7.2 (95% CI 6.0 to 8.5) during 1978-1982 and to 8.5 (95% CI 7.3 to 9.7) during 2003-2007, thus indicating a stabilising incidence over the past 35â years. The female/male ratio ranged from 1.2:1 to 1.8:1 (p=0.381) during the period. CONCLUSIONS: Stabilising rather than increasing incidence combined with the stable female/male ratio are indicative of non-fluctuating environmental factors in a geographical area otherwise characterised by lack of vitamin D effective sun exposure. The rising prevalence of MS could result from improved survival and follow-up methodology.
Assuntos
Esclerose Múltipla/epidemiologia , Adolescente , Adulto , Fatores Etários , Idade de Início , Idoso , Criança , Diagnóstico Tardio/estatística & dados numéricos , Feminino , Seguimentos , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Esclerose Múltipla/classificação , Esclerose Múltipla/diagnóstico , Esclerose Múltipla Crônica Progressiva/epidemiologia , Esclerose Múltipla Recidivante-Remitente/epidemiologia , Noruega/epidemiologia , Prevalência , Fatores Sexuais , Luz Solar , Vitamina D/metabolismo , Adulto JovemRESUMO
The major sleep disorders are common in multiple sclerosis (MS) and are associated with significant morbidity. Despite this, the rate of recognition and management of these conditions are low. All types of sleep disorders are seen in patients with MS: insomnia, circadian rhythm sleep disorders, sleep-related movement disorders, sleep-related breathing disorders, hypersomnia (narcolepsy), and parasomnia (REM sleep behavior disorder; RBD). This literature review covers the prevalence, clinical features, and treatment of sleep disorders in MS. Based on clinical experience, the spectrum of symptoms associated with MS, and the current knowledge of MS pathophysiology, we have also enclosed proposed strategies for clinical assessment and investigation of sleep disorders in MS patients.