Clinical Experience in Asian Type Multiple Sclerosis

Abstract

Multiple sclerosis is a heterogeneous disease entity, and also the most common disabling neurological disorder of people in middle life in USA. The prevalence of multiple sclerosis in Asia is lower than that in Western countries of similar latitude. Besides, there are some different features , clinically as well as pathologically, between this disease in Asia and in Western countries. We collected 27 cases diagnosed as clinically definite MS at NTUH between 1990-2000, whose clinical presentations are restricted to optic nerves and spinal cord. Their clinical charts were reviewed retrospectively, and the data was collected in a standard coding sheet. The ratio of male to female is 1:8. The average age of onset is 33. 6 years old, and the duration of illness is 10.0 years. Seventy-eight percents of total cases belong to the relapse-remitting type, 15% to the secondary progressive type, and 7% to the primary progressive type. The relapse rate is around 0.8 time/year. The most common initial symptoms are sensory loss (81%), motor weakness (74%), and paresthesia (72%). The positive rate of spine MRI is 83.3%. The segments involved most are T 2-7. Urinary retention is more common than urgency and impaired sensation. Urodynamic studies revealed 47% of cases to be the upper motor neuron type bladder. Although the impairment caused by MS is severe, only one third of patients received intensive rehabilitation. Those who received intensive rehabilitation showed improvment in both functional status and independence of ADL.