In this issue of the Archives (p 533), Gilbert and Sadler report finding unanticipated histopathologic features of multiple sclerosis (MS) in the brains of five persons in a series of 2,450 consecutive autopsies. The affected persons had reported few or no neurologic symptoms during life. Although they died in the hospital and, therefore, cannot be regarded as strictly unselected, none died of causes likely to be related to MS. Thus, there is no reason to suspect that the presence or absence of MS affected the inclusion of the patients in the series.
Furthermore, this finding was consistent with the experience of many neuropathologists working in areas with high MS prevalence. From their series, Gilbert and Sadler extrapolated an incidence of MS of 204 per 100,000 persons, a figure almost three times higher than that in high-risk areas of the United States1 and more than twice that in Canada.2
Herndon RM, Rudick RA. Multiple Sclerosis: The Spectrum of Severity. Arch Neurol. 1983;40(9):531–532. doi:10.1001/archneur.1983.04050080031002
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