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Neurology in Asia is different. The difference is due to three pairs of underlying factors: ethnic and genetic, geographical and environmental, social and cultural. These in turn affect the cause, manifestations, treatment, and outcome of neurological diseases—and so clinical neurology practice in Asia.
Multiple sclerosis (MS) is the best example of how ethnic and genetic factors determine the prevalence and manifestations of neurological disease in Asia. Almost all Asian countries have a low prevalence of MS—less than five per 100,000 population. The exceptions are those in west and central Asia, such as Israel, Kuwait, the Russians in Northern Kazakhstan and Turkmenistan, whose populations are “Caucasian”. The Parsis in India, who are of Persian descent, also have a high prevalence of MS. MS in Asia is also different from that of the West because a family history is rare, the female to male sex ratio is higher, visual involvement is more severe, the spinal cord is more severely affected, often with acute transverse myelitis and a long lesion on MRI and greater functional disability, the cerebellum is less often involved, oligoclonal bands are less frequent …