الفهرس 
DEFINITION OF MULTIPLE SCLEROSISOnly 14 pages are availabe for public view
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Abstract
M
ultiple sclerosis (MS) is a chronic autoimmune illness of the central nervous system (CNS). It is the most common autoimmune disease in young adult with peak incidence between the ages of 20 and 40 years.
The relation between MS and season of birth and between MS and vitamin D has been evident in more than one study, linked to the relapse onset and to increased progression over the disease course. Our study aimed to is to test the hypothesis whether multiple sclerosis is associated with a certain season of birth in Egyptian patient or not and its relation to vitamin D deficiency.
In the present study, 1500 Egyptian patients were included in our sample from MS Unit, Neurology department at Ain Shams University Hospital with inclusion and exclusion criterion aiming to eliminate factors that cause MS- like symptoms in different medical and neurological conditions, Vitamin D level in the serum for 100 MS (25 patients from each season) will be determined.
We found prevalence of MS was higher in spring (27.3%); while prevalences in (summer, autumn and winter); were (26.2%, 24% and 22.5% respectively).
Regarding season of birth, our clinical determents for MS course and progression showed that there is highly significant increase in age and age of disease onset in summer-born patients; compared to patients born in other seasons (p = 0.021, p =0.001 respectively). Also, there were significant decrease in disease duration in summer and spring groups; compared to autumn and winter groups (p = 0.043)AND significant increase in MS progression in spring season compared to the other 3 seasons; with significant statistical difference (p = 0.04).
However, there was no significant association with the rest of possible determinants in our study like sex, EDSS, total number of relapses and MS type.
Regarding vitamin D, disease duration was significantly lower in sufficiency group compared to insufficiency group; with significant statistical difference (p = 0.049). A total relapses and EDSS score was significantly lower in sufficiency group compared to insufficiency group; with significant statistical difference (p = 0.042, p = 0.038 respectively).
However, there was no significant association with the rest of possible determinants in our study like sex, MS type, age, age of onset and, there was non-significant difference as regards vitamin D level (p > 0.05) between 4 seasons but D level was relatively low in summer and autumn compared to spring and winter.