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Multiple Sclerosis, Neuromyelitis Optica, Concentric Sclerosis, and Schilder’s Diffuse Sclerosis

  • Jacob Valk
  • Marjo S. van der Knaap
Chapter

Abstract

Multiple sclerosis (MS) is the most common demyelinating disorder of the CNS. The peak incidence is at 30 years of age. MS rarely commences in childhood or over the age of 50 years. Females are affected twice as frequently as males. MS shows a characteristic geographical distribution. It is rare in tropical areas and increases in frequency at higher latitudes. It has been estimated, for example, that the prevalence rate in the United States varies from 6–14 per 100000 inhabitants in the southern states to about 40–60 per 100000 inhabitants in the northern states. No definite relationship has been established with the climatic characteristics of the latitude. Within this overal latitudinal distribution a rather large range of incidences of MS has been observed at the same latitudes. Incidental clusters of MS have been reported. In these instances a remarkable number of patients acquire MS within a short period of time (a few months), and they share a common exposure in their history. Etiologic factors for these MS pockets are as yet unknown. Sometimes such clusters of MS assume the proportions of an epidemic, the incidence of MS rising over a period of several years in a larger area. In these cases the nature of the introduced environmental factor or factors also still remains to be elucidated. The importance of environmental factors is stressed by the findings of migrational studies. A decrease in the risk of developing MS has been noted in young individuals migrating from high-risk to low-risk areas and an increase in risk after migration from low-risk to high-risk areas. Such changes in risk have not been found in older individuals, and the data suggest that the risk of acquiring MS is largely established around the age of 15. There is also increasing evidence for a genetically influenced susceptibility to MS. In general, first-degree relatives of probands have a risk that is 30–50 times greater than the risk for the general population.

Keywords

Multiple Sclerosis White Matter Human Leukocyte Antigen Multiple Sclerosis Patient Myelin Basic Protein 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Springer-Verlag Berlin Heidelberg 1989

Authors and Affiliations

  • Jacob Valk
    • 1
  • Marjo S. van der Knaap
    • 2
  1. 1.Department of Diagnostic Radiology and NeuroradiologyFree University HospitalAmsterdamThe Netherlands
  2. 2.Department of Child NeurologyAcademic HospitalUtrechtThe Netherlands

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