Multiple sclerosis in Malaysia

Thirty consecutive patients from peninsular Malaysia with clinically definite multiple sclerosis were studied; 80% were ethnic Chinese, with a female-male ratio of 5:1. The average age at onset was 29.7 years, with one relapse average every 1.9 years. Optic-spinal recurrence was the most common clinical pattern of the disease, accounting for 63.3% (19/30) of the cases. All the patients had spinal cord involvement sometime during the course of the illness. The mortality was high at 36.7% (11/30), with an average duration of symptoms of 7.6 years. There was characteristic severe residual visual and motor disability. At the time of the last examination, 12 patients had bilateral optic atrophy with blindness or severe visual acuity impairment. Sixteen patients were bedridden or confined to a wheelchair. The severe motor disability reflected the severe spinal cord involvement. It was the main factor that accounted for the high mortality. The cerebral, cerebellar, and brain-stem involvements were, however, generally transient. None of the patients' had a family history of similar illness despite the average sibling size of six. There was no example of Devic's disease. The clinical pattern was closest to those patients who presented from Taiwan.