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Multiple sclerosis in Malaysia
1Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur.
Abstract:
Thirty consecutive patients from peninsular Malaysia with clinically definite multiple sclerosis were studied; 80% were ethnic Chinese, with a female-male ratio of 5:1. The average age at onset was 29.7 years, with one relapse average every 1.9 years. Optic-spinal recurrence was the most common clinical pattern of the disease, accounting for 63.3% (19/30) of the cases. All the patients had spinal cord involvement sometime during the course of the illness. The mortality was high at 36.7% (11/30), with an average duration of symptoms of 7.6 years. There was characteristic severe residual visual and motor disability. At the time of the last examination, 12 patients had bilateral optic atrophy with blindness or severe visual acuity impairment. Sixteen patients were bedridden or confined to a wheelchair. The severe motor disability reflected the severe spinal cord involvement. It was the main factor that accounted for the high mortality. The cerebral, cerebellar, and brain-stem involvements were, however, generally transient. None of the patients' had a family history of similar illness despite the average sibling size of six. There was no example of Devic's disease. The clinical pattern was closest to those patients who presented from Taiwan.
Insights
This study on multiple sclerosis (MS) in Malaysia found a severe optic-spinal pattern with high mortality. MS patients experienced significant visual and motor disability, highlighting the disease
Area of Science:
- Neurology
- Clinical Medicine
- Epidemiology
Background:
- Multiple sclerosis (MS) is a chronic neurological disorder.
- Understanding the clinical patterns and outcomes of MS in diverse populations is crucial.
Purpose of the Study:
- To characterize the clinical presentation, disease course, and outcomes of multiple sclerosis in peninsular Malaysia.
- To identify specific demographic and clinical features of MS in this ethnic Chinese-predominant cohort.
Main Methods:
- A consecutive series of 30 patients with clinically definite multiple sclerosis were studied.
- Data collected included demographics, clinical patterns, relapse rates, disability progression, and mortality.
Main Results:
- The study cohort was predominantly ethnic Chinese (80%) with a 5:1 female-to-male ratio and average age at onset of 29.7 years.
- Optic-spinal recurrence was the most common pattern (63.3%), with all patients experiencing spinal cord involvement.
- High mortality (36.7%) and severe visual and motor disability were observed, with spinal cord involvement being a key factor.
Conclusions:
- Multiple sclerosis in peninsular Malaysia presents with a severe optic-spinal pattern and high mortality.
- The disease course is characterized by significant disability, particularly affecting vision and motor function.
- The clinical phenotype appears distinct and shares similarities with MS patients from Taiwan.