A Review of Geoepidemiological Differences of Multiple Sclerosis in Iran and Other Middle East Countries

Abstract

Context: Review of epidemiological studies of different geographical regions show a wide variation in the prevalence of multiple sclerosis (MS) worldwide. This study compares related geoepidemiological differences in prevalence of MS in the Middle East. Evidence Acquisition: Key words relevant to "prevalence of multiple sclerosis" were searched for with countries in the Middle East. Results: A prevalence of 31-55 per 100,000 individuals has been reported for Persian Gulf countries. The reported prevalence per Kuwait (n = 85.05) and United Arab Emirate (n = 54.4) seems to be high. The reported prevalence for Turkey and Jordan were 51 and 20, correspondingly. Within Iran, the highest and lowest prevalence seem to belong to Isfahan (n = 93.06) and Golestan (n = 18.0), respectively. Immunomodulating drugs such as Interferon-beta as a first-line therapy; and cyclophosphamide, methotrexate, mitoxantrone, and azathioprine have been considered as second-line therapies. Conclusions: The high prevalence of MS in the Middle East might be pointed toward the adverse effects of low vitamin D, individual daily life, smoking, Epstein-Barr virus infection, hereditary affects, and a history of depression.