Multiple sclerosis in Brazil: A systematic review

•Profile of MS in Brazil is similar to that observed in high-MS-prevalence areas.•Classic predictors of long-term disability were reproduced in Brazil.•African ancestry is a risk factor to disability and early progression.

BackgroundThe 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.ObjectiveTo review and synthesize available data about MS in Brazil.Material and methodsSystematic review was performed through a search of medical literature databases to identify Brazilian studies published during 1990-2012.Data sourcesPubMed, 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”.ResultsIn 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.ConclusionsThe 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.