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{{Template:Multiple sclerosis}}
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==Overview==
==Overview==
The majority of multiple sclerosis cases are reported in northern Europe, continental North America, and Australasia, which is about one of every 1000 citizens. Factors including sunlight exposure, climate, [[diet]], [[toxins]], [[genetic]] factors, geomagnetism, childhood environmental factors, and [[infections]] have been proved to cause the differences in [[MS]] prevalence. [[MS]] is at least two times more common among [[women]] than [[men]]. The onset of [[symptoms]] is mostly between the age of fifteen to forty years, rarely before age fifteen or after age sixty.
== Epidemiology and Demographics==
== Epidemiology and Demographics==
=== Incidence ===
* The [[incidence]] of multiple sclerosis is approximately 200 new cases per week in united state.
=== Prevalence ===
* The [[prevalence]] of [[MS]] varies among countries. according to some studies [[MS]] occurs mostly in Caucasians while it is rare in the Native American tribes of North America, Australian Aborigines and the Māori of New Zealand.
* Among countries Scotland seems to have the highest rate of [[MS]] in the world.<ref>{{cite journal |author=Rothwell PM, Charlton D |title=High incidence and prevalence of multiple sclerosis in south east Scotland: evidence of a genetic predisposition |journal=J. Neurol. Neurosurg. Psychiatr. |volume=64 |issue=6 |pages=730-5 |year=1998 |pmid=9647300 |doi=}}</ref>
* We can conclude that due to [[genetic]] susceptibility, [[lifestyle]] and different culture, the development of this [[disease]] is not equal in various regions.
=== Case-fatality rate/Mortality rate ===
=== Age ===
* The onset of [[symptoms]] is mostly between the age of fifteen to forty years, rarely before age fifteen or after age sixty.


In northern Europe, continental North America, and Australasia, about one of every 1000 citizens suffers from multiple sclerosis, whereas in the Arabian peninsula, Asia, and continental South America, the frequency is much lower. In sub-Saharan Africa, MS is extremely rare. With important exceptions, there is a north-to-south gradient in the northern hemisphere and a south-to-north gradient in the southern hemisphere, with MS being much less common in people living near the equator.<ref>[http://www.fedem.org/revista/n16/kurtzkeing.htm Epidemiology and multiple sclerosis. a personal review]</ref> Climate, [[diet (nutrition)|diet]], geomagnetism, [[toxin]]s, [[sunlight]] exposure, genetic factors, and [[infectious disease]]s have all been discussed as possible reasons for these regional differences. Environmental factors during childhood may play an important role in the development of MS later in life. This idea is based on several studies of migrants showing that if migration occurs before the age of fifteen, the migrant acquires the new region's susceptibility to MS. If migration takes place after age fifteen, the migrant keeps the susceptibility of his home country.<ref>Marrie, RA. ''Environmental risk factors in multiple sclerosis aetiology.'' Lancet Neurol. 2004 Dec;3(12):709-18. Review. PMID 15556803</ref> However other works suggest that the age/geographical risk for developing multiple sclerosis spans a larger timescale than just the first 15 years of life.<ref name="pmid10775541">{{cite journal |author=Hammond SR, English DR, McLeod JG |title=The age-range of risk of developing multiple sclerosis: evidence from a migrant population in Australia |journal=Brain |volume=123 ( Pt 5) |issue= |pages=968–74 |year=2000 |pmid=10775541 |doi=}}</ref>
=== Race ===
* [[MS]] [[prevalence]] is lower in African Americans, Mexicans, Japanese, Chinese and Filipinos people rather than white men.<ref name="pmid573402">{{cite journal |vauthors=Kurtzke JF, Beebe GW, Norman JE |title=Epidemiology of multiple sclerosis in U.S. veterans: 1. Race, sex, and geographic distribution |journal=Neurology |volume=29 |issue=9 Pt 1 |pages=1228–35 |date=September 1979 |pmid=573402 |doi= |url=}}</ref>


MS occurs mainly in Caucasians. It is twentyfold lower in the Inuit people of Canada than in other Canadians living in the same region. It is also rare in the Native American tribes of North America, Australian Aborigines and the Māori of New Zealand. Scotland appears to have the highest rate of MS in the world.<ref> {{cite journal |author=Rothwell PM, Charlton D |title=High incidence and prevalence of multiple sclerosis in south east Scotland: evidence of a genetic predisposition |journal=J. Neurol. Neurosurg. Psychiatr. |volume=64 |issue=6 |pages=730-5 |year=1998 |pmid=9647300 |doi=}}</ref>  The reasons for this are unknown. These few examples point out that either genetic background or lifestyle and cultural factors play an important role in the development of MS.
=== Gender ===
* [[Autoimmune disorders]] such as [[MS]] is at least two times more common among [[women]] than [[men]] but this difference will disappear after the age of 50 and in children reach three females for each male.


As observed in many autoimmune disorders, MS is more common in females than males; the mean sex [[ratio]] is about two females for every male. In children (who rarely develop MS) the sex ratio may reach three females for each male. In people over age fifty, MS affects males and females equally. Onset of symptoms usually occurs between fifteen to forty years of age, rarely before age fifteen or after age sixty.
=== Region ===
* The majority of multiple sclerosis cases are reported in northern Europe, continental North America, and Australasia, which is about one of every 1000 citizens while there is a lower frequency of people suffering from Multiple Sclerosis among citizens of the Arabian Peninsula, Asia, and continental South America. In addition, in sub-Saharan Africa, [[MS]] is extremely rare.<ref>[http://www.fedem.org/revista/n16/kurtzkeing.htm Epidemiology and multiple sclerosis. a personal review]</ref>


As previously discussed, there is a genetic component to MS. On average one of every 25 siblings of individuals with MS will also develop MS. Almost half of the [[identical twin]]s of MS-affected individuals will develop MS, but only one of twenty fraternal twins. If one parent is affected by MS, each child has a risk of only about one in forty of developing MS later in life.<ref>Sadovnick, AD, Ebers, GC, Dyment, DA, Risch, NJ. ''Evidence for genetic basis of multiple sclerosis. The Canadian Collaborative Study Group.'' Lancet 1996; 347:1728. PMID 8656905</ref>
* Factors including sunlight exposure, climate, [[diet]], [[toxins]], [[genetic]] factors, geomagnetism, Childhood environmental factors and [[infections]] have been proved to cause this differences in [[MS]] prevalence.  
* Several studies demonstrated that if immigration occurs before the age of fifteen, the migrant's susceptibility to [[MS]] will be equal to that region's native people, But if migration occurs after the age of fifteen, the migrant's susceptibility will remain equal to his home country.<ref>Marrie, RA. ''Environmental risk factors in multiple sclerosis etiology.'' Lancet Neurol. 2004 Dec;3(12):709-18. Review. PMID 15556803</ref>
It is important to say that some studies on related [[diseases]] have shown that some diseases which were formerly considered [[MS]] cases are not [[MS]] at all. all the studies before 2004 can be affected because of inability to distinguish [[MS]] and [[Devic's disease]] (NMO).<ref>{{cite journal |author=Weinshenker B |title=Western vs optic-spinal MS: two diseases, one treatment?|journal=Neurology |volume=64 |issue=4 |pages=594-5 |year=2005 |pmid=15728277}}</ref>


Finally, it is important to remark that advances in the study of related diseases have shown that some cases formerly considered MS are not MS at all. In fact, all the studies before 2004 can be affected by the impossibility to distinguish MS and [[Devic's disease|''Devic's disease'' (NMO)]] reliably before this date. The error can be important in some areas, and is considered to be 30% in Japan.<ref>{{cite journal |author=Weinshenker B |title=Western vs optic-spinal MS: two diseases, one treatment?|journal=Neurology |volume=64 |issue=4 |pages=594-5 |year=2005 |pmid=15728277}}</ref>
[[File:1200px-Multiple sclerosis world map-Deaths per million persons-WHO2012.svg.png|500px|none|thumb|Data from World Health Organization Estimated Deaths 2012 Vector map from BlankMap-World6, compact.svg by Canuckguy et al [https://en.wikipedia.org/wiki/File:Multiple_sclerosis_world_map-Deaths_per_million_persons-WHO2012.svg]]]
<gallery>


Image:MS Risk.jpg|World map showing that risk for MS increases with greater distance from the equator
<br />


</gallery>
==References==
==References==
{{reflist|2}}
{{reflist|2}}
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[[Category:Neurology]]
[[Category:Orthopedics]]
[[Category:Rheumatology]]

Latest revision as of 22:47, 29 July 2020

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [2]; Associate Editor(s)-in-Chief: Fahimeh Shojaei, M.D.

Overview

The majority of multiple sclerosis cases are reported in northern Europe, continental North America, and Australasia, which is about one of every 1000 citizens. Factors including sunlight exposure, climate, diet, toxins, genetic factors, geomagnetism, childhood environmental factors, and infections have been proved to cause the differences in MS prevalence. MS is at least two times more common among women than men. The onset of symptoms is mostly between the age of fifteen to forty years, rarely before age fifteen or after age sixty.

Epidemiology and Demographics

Incidence

  • The incidence of multiple sclerosis is approximately 200 new cases per week in united state.

Prevalence

  • The prevalence of MS varies among countries. according to some studies MS occurs mostly in Caucasians while it is rare in the Native American tribes of North America, Australian Aborigines and the Māori of New Zealand.
  • Among countries Scotland seems to have the highest rate of MS in the world.[1]
  • We can conclude that due to genetic susceptibility, lifestyle and different culture, the development of this disease is not equal in various regions.

Case-fatality rate/Mortality rate

Age

  • The onset of symptoms is mostly between the age of fifteen to forty years, rarely before age fifteen or after age sixty.

Race

  • MS prevalence is lower in African Americans, Mexicans, Japanese, Chinese and Filipinos people rather than white men.[2]

Gender

  • Autoimmune disorders such as MS is at least two times more common among women than men but this difference will disappear after the age of 50 and in children reach three females for each male.

Region

  • The majority of multiple sclerosis cases are reported in northern Europe, continental North America, and Australasia, which is about one of every 1000 citizens while there is a lower frequency of people suffering from Multiple Sclerosis among citizens of the Arabian Peninsula, Asia, and continental South America. In addition, in sub-Saharan Africa, MS is extremely rare.[3]
  • Factors including sunlight exposure, climate, diet, toxins, genetic factors, geomagnetism, Childhood environmental factors and infections have been proved to cause this differences in MS prevalence.
  • Several studies demonstrated that if immigration occurs before the age of fifteen, the migrant's susceptibility to MS will be equal to that region's native people, But if migration occurs after the age of fifteen, the migrant's susceptibility will remain equal to his home country.[4]

It is important to say that some studies on related diseases have shown that some diseases which were formerly considered MS cases are not MS at all. all the studies before 2004 can be affected because of inability to distinguish MS and Devic's disease (NMO).[5]

Data from World Health Organization Estimated Deaths 2012 Vector map from BlankMap-World6, compact.svg by Canuckguy et al [1]


References

  1. ↑ Rothwell PM, Charlton D (1998). "High incidence and prevalence of multiple sclerosis in south east Scotland: evidence of a genetic predisposition". J. Neurol. Neurosurg. Psychiatr. 64 (6): 730–5. PMID 9647300.
  2. ↑ Kurtzke JF, Beebe GW, Norman JE (September 1979). "Epidemiology of multiple sclerosis in U.S. veterans: 1. Race, sex, and geographic distribution". Neurology. 29 (9 Pt 1): 1228–35. PMID 573402.
  3. ↑ Epidemiology and multiple sclerosis. a personal review
  4. ↑ Marrie, RA. Environmental risk factors in multiple sclerosis etiology. Lancet Neurol. 2004 Dec;3(12):709-18. Review. PMID 15556803
  5. ↑ Weinshenker B (2005). "Western vs optic-spinal MS: two diseases, one treatment?". Neurology. 64 (4): 594–5. PMID 15728277.

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