Clinical and epidemiological aspects of multiple sclerosis in Japan

A review of the studies of Japanese MS is presented. The epidemiological studies showed a prevalence rate of 1-4 per 100,000 population with higher rates in the northern regions. The lower rates compared with the western countries of similar latitudes might show the racial suppressive factor. The clinical and pathological studies supported the existence of the Oriental or Asian features of MS in a form of severe hyperergic demyelinating reactions. Severe visual loss and transverse myelopathy were predominantly common in the Oriental MS which was consistently different from Caucasian MS. Inflammatory reaction in the CSF was also prominent. The etiology showed the need for a basic protein plus alpha to provoke the chronic relapsing demyelinating process. Consideration of three factors; essential causative factor (C), trigger factor (T) and endogenous regulatory factor (R), is necessary for the pathogenesis of MS.