An epidemiological study of neuromyelitis optica in Cuba
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Two population-based studies of neuromyelitis optica (NMO) in non-white populations provided prevalence rates of 0.32 and 3.1 per 100,000 population.
To estimate NMO prevalence in the multiethnic Cuban population by nation-wide case ascertainment.
The study was conducted from October 1, 2003 to November 30, 2004 . Ninety percent of general practitioners and all neurologists responded positively to the request for information on cases suspected of optic neuritis (ON), transverse myelitis (TM), multiple sclerosis, or NMO. Among the population of 11,177,743 there were 798 suspected cases, including 89 with possible NMO, relapsing ON (RON) and TM. Of the 89, 87 were examined by two of us (Cabrera JA, Lara R) who selected the NMO cases according to the 1999 Mayo Clinic criteria as well as those with relapsing TM and RON.
58 cases provided a prevalence rate of 0.52 per 100,000 (95 % CI 0.39–0.67). The 7 males and 51 females gave rates of 0.13 (CI 0.05–0.26) and 0.91 (CI 0.68–1.20). The estimated average annual incidence rate was 0.053 per 100,000 (CI 0.040–0.068). Prevalence rates did not differ significantly among the three ethnic groups. Black NMO cases were significantly older, with more relapses and motor deficit, as well as more abnormalities in brainstem evoked potentials and in brain MRI (not meeting MS criteria). The predominant clinical form was relapsing over monophasic.
This Cuban multiethnic population had a prevalence of NMO of 0.52 per 100,000 and an estimated average annual incidence rate of 0.053 per 100,000 with no differences by ethnicity. Black patients were older, with more relapses and motor impairment.
Key wordsneuromyelitis optica relapsing neuromyelitis optica multiple sclerosis Devic’s disease prevalence epidemiology incidence
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- 1.Wingerchuk DM, Hogancamp WF, O’Brien PC, Weinshenker BG (1999) The clinical course of neuromyelitis optica (Devic’s syndrome). Neurology 53:107–1114Google Scholar
- 3.Wingerchuck D, Weinshenker B (2003) Neuromyelitis optica: clinical predictors of a relapsing course and survival. Neurology 60:848–853Google Scholar
- 18.Saiz A, Zuliani L, Blanco Y, Tavolato B, Giometto B, Grauss F, for the Spanish- Italian NMO study group (2007) Revised diagnostic criteria for neuromyelitis optica (NMO): application in a series of suspected patients. J Neurol (Epub ahead of print)Google Scholar
- 19.Rilling G, Fretz C, Ludin HP (1999) Recurrent retrobulbar neuritis and extensive myelitis: MS or optic neuromyelitis? Schweiz Rundsch Med Prax 88:2071–2076Google Scholar
- 20.Sebastian de la Cruz F, Lopez-Dolado E (1999) Neuromielitis optica: analisis de siete casos. Rev Neurol 28:476–482Google Scholar
- 31.Tan CT, Chong HT (1999) Devic’s disease and multiple sclerosis in Asia. Neurol J Southeast Asia 4:57–59Google Scholar
- 32.Chon HT, Li PC, Ong B, et al. (2002) Severe spinal cord involvement is a universal feature of Asians with multiple sclerosis: A joint Asian study. Neurol J South East Asia 7:35–40Google Scholar
- 34.Hidalgo PC (1998) The genetic constitution of the Cuban population. Rev Esp Antrop Biol 19:5–20Google Scholar
- 39.Siegel S (1956) Nonparametric Statistics for the Behavioral Sciences. McGraw Hill, New York, pp 184–193Google Scholar
- 41.Nelson LM, McGuire VM (2004) Study design, measures of effect, and sources of bias. In: Nelson LM, Tanner CM, Van Den Eeden SK, McGuire VM (eds) Neuroepidemiology. From Principles to Practice. Oxford University Press, New York, pp 23–54 (Chapter 2)Google Scholar