title: Multiple sclerosis in Brazil: A systematic review.
abstract: BACKGROUND
  The 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.
  
  
  OBJECTIVE
  To review and synthesize available data about MS in Brazil.
  
  
  METHODS
  Systematic review was performed through a search of medical literature databases to identify Brazilian studies published during 1990-2012.
  
  
  METHODS
  PubMed, SciELO, and Lilacs.
  
  
  BACKGROUND
  "Brazil" or "Brazilian" combined with the following terms: "multiple sclerosis", "clinical profile", "demographic profile", "natural history", "clinical course", "pediatric", or "familial form".
  
  
  RESULTS
  In 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.
  
  
  CONCLUSIONS
  The 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.
authors.affiliation: Universidade Federal do Estado do Rio de Janeiro, Rua Mariz e Barros 775, Departamento de Neurologia-Tijuca, Rio de Janeiro, CEP: 20270-901, Brazil. Electronic address: cfvas@hotmail.com.
authors.forename: C C F
authors.initials: CC
authors.lastname: Vasconcelos
authors.affiliation: Universidade Federal do Estado do Rio de Janeiro and Instituto Nacional de Câncer , Rua André Cavalcanti, 37, Centro, Rio de Janeiro, RJ, CEP: 20231-050, Brazil. Electronic address: lthuler@gmail.com.
authors.forename: L C S
authors.initials: LC
authors.lastname: Thuler
authors.affiliation: Universidade Federal do Estado do Rio de Janeiro, Rua Mariz e Barros 775, Departamento de Neurologia-Tijuca, Rio de Janeiro, CEP: 20270-901, Brazil. Electronic address: bernardocrs@gmail.com.
authors.forename: B C
authors.initials: BC
authors.lastname: Rodrigues
authors.affiliation: Universidade Federal do Estado do Rio de Janeiro, Rua Mariz e Barros 775, Departamento de Neurologia-Tijuca, Rio de Janeiro, CEP: 20270-901, Brazil. Electronic address: anacalmon@uol.com.br.
authors.forename: A B
authors.initials: AB
authors.lastname: Calmon
authors.affiliation: Universidade Federal do Estado do Rio de Janeiro and Hospital Federal da Lagoa , Rua Mariz e Barros 775, Departamento de Neurologia-Tijuca, Rio de Janeiro, CEP: 20270-901, Brazil. Electronic address: regina_alvarenga2004@hotmail.com.
authors.forename: R M P
authors.initials: RM
authors.lastname: Alvarenga
mesh_terms: D000328:Adult; D001938:Brazil / Q000453:epidemiology; D002648:Child; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D009103:Multiple Sclerosis / Q000453:epidemiology* / Q000503:physiopathology*
keywords: Brazilian profile; Clinical course; Multiple sclerosis; Natural history; Prognostic factors; Systematic review