Multiple sclerosis in India: An overview

Area of Science:

• Neurology
• Neuroimmunology
• Epidemiology

Background:

• Multiple sclerosis (MS) diagnosis rates are increasing in India.
• Increased availability of neurologists and magnetic resonance imaging (MRI) contribute to higher diagnosis rates.
• Clinical presentation and disease course in Indian MS patients largely resemble those in Western populations.

Purpose of the Study:

• To review the current landscape of multiple sclerosis diagnosis and management in India.
• To differentiate classical MS from neuromyelitis optica (NMO), previously termed optico-spinal MS.
• To discuss the availability and accessibility of disease-modifying therapies (DMTs) in India.

Main Methods:

• Review of clinical features and diagnostic criteria for MS and NMO.
• Analysis of MRI findings in differentiating MS from NMO.
• Assessment of the availability and cost of DMTs in the Indian market.

Main Results:

• The term 'optico-spinal MS' (Asian MS) predates MRI and often misdiagnosed NMO.
• MRI scans help differentiate classical MS from NMO, a distinct neurological disorder.
• Several DMTs for MS are available in India, but their high cost restricts widespread use.

Conclusions:

• Accurate diagnosis differentiating MS from NMO is essential in India.
• While MS treatments are available, cost remains a significant barrier to patient access.
• Further research and policy interventions are needed to improve MS care in India.