Multiple sclerosis in Brazil: A systematic review

Background: The natural history of multiple sclerosis (MS) in Brazil has been available in different regions of country. There is no nationwide population-based studies that express general data in Brazil. Objective: To review and synthesize available data about MS in Brazil. Material and methods: Systematic review was performed through a search of medical literature databases to identify Brazilian studies published during 1990-2012. Data sources: PubMed, SciELO, and Lilacs. Keywords: Brazil or Brazilian combined with the following terms: multiple sclerosis, clinical profile, demographic profile, natural history, clinical course, pediatric, or familial form. Results: In total of 45 pediatric and 1922 adult patients, the median age at onset was 10 years in pediatric patients and 32 years in adult patients. Women were more affected. Motor-control complaints and relapsing-remitting phenotype at onset were the most common. Predictors to disability and progression were number of relapses during the first year of disease, older age, male gender and African ancestry. Conclusions: The profile of the MS in Brazilian seems to correspond to that observed in high-MS prevalence areas. African ancestry is a risk factor to disability and progression early. In Brazil, factors that limit MS incidence do not interfere with the clinical pattern and outcomes. (C) 2016 Elsevier B.V. All rights reserved.