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• The number of publications by researchers affiliated with neurosurgical centers in Southeast Asia showed an increasing trend up to 2019. • A country's percentage of the GDP allocated to research and development was positively correlated with the number of publications, total citations, h-index, and i(10)-index. • A country's number of collaborations with non-SEA researchers also positively correlated with the same indices. Bibliometric analysis can provide insight into the growth, development and dissemination of research in neurosurgery. Little work has been done to examine the role of country-specific characteristics affecting research productivity. We aimed to characterize and compare the research productivity among SEA countries in terms of bibliometric indices and determine associations with country-specific factors. We performed a systematic search of all articles by authors affiliated with a neurosurgical department in any of the Southeast Asian countries, indexed in 3 databases from inception to June 10, 2020. Bibliometric indices – number of publications, number of citations, average citations per publication, h-index, and the i-10-index – were computed for each country. Correlations between the indices and country-specific characteristics (population size, GDP per capita, percentage of GDP allocation to research and development (R&D), number of neurosurgeons, number of neurosurgeons per capita, and number of collaborations with non-SEA authors) were determined. The number of publications showed an increasing trend up to 2019. Most studies were cohort studies (37%) or case reports or series (37%). Of the country-specific factors analyzed, only percentage of the GDP allocated to R&D was positively correlated with number of publications (p = 0.0004), total citations (p < 0.0001), H-index (p < 0.0001), and i(10)-index (p < 0.0001). Number of collaborations also positively correlated with the same indices. Our bibliometric analysis showed increasing contribution by neurosurgeons in the SEA region. Correlational analysis support the view that increased R&D budget allocation and international collaboration can improve neurosurgical research capacity and productivity. [ABSTRACT FROM AUTHOR]

• Data on pediatric acquired demyelinating syndromes (PADS) in the Philippines is lacking. • A total of 77 patients with PADS were identified at our institution. • The most common PADS subtypes were TM, ADEM and MS. • IVMP is the most utilized treatment during an acute demyelinating attack. • The majority of patients with PADS experienced partial recovery. Epidemiological data on the pediatric acquired demyelinating syndromes (PADS) in the Philippines has not been described previously in the literature. There may be geographic differences in frequencies of PADS where true disease burden is not known or underestimated in resource-limited settings due to lack of case recognition and/or diagnostic facilities. The purpose of this study was to determine the frequencies and clinical characteristics of the different subtypes of PADS at our institution and compare these with those in published literature. We conducted a retrospective cross-sectional study of children diagnosed with PADS who were admitted at the Philippine General Hospital from January 2009 to December 2018. Charts of these patients were reviewed to determine frequencies, clinical profile, diagnostic findings and outcomes. A total of 77 patients were identified with PADS using the appropriate diagnostic criteria. The frequencies of the PADS subtypes were the following: transverse myelitis (n = 21; 27.3 %); acute disseminated encephalomyelitis (n = 20, 26.0 %); multiple sclerosis (n = 17, 22.1 %); optic neuritis (n = 13, 16.9 %); clinically isolated syndrome (n = 4, 5.2 %); and neuromyelitis optica spectrum disorder (n = 2, 2.6 %). Overall, the mean age at initial event and at diagnosis were 10.6 ± 4.6 years. Female:male ratio was 1.02:1. On admission, the majority of patients had motor paralysis (n = 49, 63.6 %) while several patients manifested with sensory deficits (n = 31, 40.3 %), visual changes (n = 26, 33.8 %) and brainstem involvement (n = 20, 26.0 %). Nearly all patients had evidence of lesions in magnetic resonance imaging (n = 72, 93.5 %) located in spinal cord (n = 25; 32.5 %), cerebral white matter (n = 24; 31.2 %), and optic nerve (n = 12, 15.6 %). Among patients who underwent cerebrospinal fluid analysis (n = 34), 7 patients had abnormal findings (20.6 %). The most utilized treatment regimens during admission were intravenous methylprednisolone (n = 53, 68.8 %) and oral prednisone (n = 43, 55.8 %). The majority had partial recovery (n = 56, 72.7 %) and 16 experienced full recovery (20.8 %) at discharge. Five patients died (6.5 %). Our study provided the first comprehensive summary on the clinical features of children with PADS admitted in a Philippine tertiary hospital with limited resources. Our study highlights the value of using clinical diagnostic criteria in improving case recognition especially in low-and middle-income countries. Regional disparities in disease burden warrant international registries with wider geographic representation in order to come up with diagnostic and management guidelines suitable for various levels of care. [ABSTRACT FROM AUTHOR]

• Autoimmune encephalitis (AE) is an emerging, potentially reversible disease. • We presented eighteen Filipino adults and children with definite AE. • The most frequently noted manifestation is psychiatric disturbance. • Imaging, EEG, and CSF findings were nonspecific, but may still guide diagnosis. • Most patients improved with treatment, especially those who were treated early. Autoimmune encephalitis (AE) is an emerging disorder in adults and children. Due to its potentially reversible nature, prompt recognition and intervention are of utmost importance. To describe the clinical and paraclinical features, as well as treatment outcomes of patients with AE admitted in a Philippine tertiary hospital. Retrospective case series of patients with definite AE. Eighteen (18) patients were included (12 adults, 6 children), majority of whom had anti-N-methyl- d -aspartate receptor (NMDAR) encephalitis. The median age of onset was 32 (IQR: 10.8) years old and 13 (IQR: 4.8) years old in the adult and pediatric population, respectively. In both age groups, most presented with psychiatric symptoms and normal imaging findings. Cerebrospinal fluid (CSF) pleocytosis was detected in 8/12 (66.7%) adults and 2/6 (33.3%) children, while CSF protein elevation was only seen in 6/12 (50%) adults. Most patients presented with seizures, and the most frequent electroencephalography (EEG) abnormality detected was slow activity (70.5%). A high proportion of patients received high dose steroids, alone (35.3%) or in combination with intravenous immunoglobulin (IVIG, 52.9%). Overall, 66.7% had improved outcomes, mostly seen in the pediatric population. This study highlighted the broad clinical phenotype, as well as the similarities and differences of AE manifestations in adults and children. It demonstrated the limited but supportive role of laboratory investigations in the diagnosis of AE. It also underscored the importance of early intervention in AE and highlighted factors influencing treatment practices and discharge outcomes in the local setting. [ABSTRACT FROM AUTHOR]

Background: The number of scientific publications on movement disorders from Southeast Asia (SEA) is thought to be low. Thus, we looked at the movement disorders research productivity among SEA countries and its associations with country-specific socioeconomic factors.Methods: We performed a systematic search for publications indexed in PubMed, Scopus, Embase and Cochrane Central Register of Controlled Trials from January 2000 to December 2019 with at least one author from SEA. Bibliometric indices were used to evaluate research impact. The country-specific socioeconomic characteristics were also obtained.Results: Of the 9488 identified articles, 1567 met the eligibility criteria. There was an increasing trend in the total number of publications on movement disorders during the last two decades. Singapore had the highest contribution in all aspects, which highlights the impact of knowledge-based economy type in research productivity. Parkinsonism remained the most studied condition, followed by dystonia, chorea, and tremor. Among the socioeconomic factors, only % gross domestic product (GDP) for research and development showed a positive correlation on the number of publications of a country. On the other hand, GDP per capita, population size and the number of neurologist size did not affect research productivity.Conclusions: An increasing trend in the movement disorders research output over the last 20 years was seen. Singapore had the highest contribution in all aspects which highlights the impact of economy in research productivity. Among the socioeconomic factors, only % GDP for R&D showed a positive impact on the number of publications of a country. [ABSTRACT FROM AUTHOR]

Background: Growing evidence of neurologic involvement seen in COVID-19 infection necessitates the pooling of neurodiagnostic findings like electroencephalography (EEG) that may guide clinical management. The objective of this study was to review the EEG findings in patients diagnosed with COVID-19 infection through a systematic review of published articles.Methods: We systematically searched until July 25, 2020 for published articles that reported on descriptive EEG findings in patients diagnosed with COVID-19 in PUBMED by Medline, EMBASE, and CENTRAL by the Cochrane Library.Results: From a total of 94 identified records, 29 relevant articles were included in this review. A total of 177 patients with COVID-19 with descriptive EEG reports were analyzed. The most common indication for EEG was unexplained altered mental status. Disturbances of background activity such as generalized and focal slowing were seen as well epileptiform abnormalities and rhythmic or periodic discharges. There were no consistent EEG findings specific to COVID-19 infection.Conclusion: The EEG findings in COVID-19 appear to be non-specific. Further research on the relationship of the EEG findings to the clinical state and short- or long-term prognosis of COVID-19 patients may be conducted to help clinicians discern which patients would necessitate an EEG procedure and would eventually require treatment. [ABSTRACT FROM AUTHOR]

Congenital glioblastoma multiforme (cGBM) is an infrequent primary central nervous system tumor occurring within the first few months of life with a reported poor overall prognosis. Our objective was to describe our own clinical case of cGBM and review the literature of cGBM cases with prolonged survival. We report a case of cGBM with prolonged survival at 4 years. A systematic review was conducted on cases of cGBM with long-term childhood survival. We searched online databases until August 2019 for relevant articles. The patient underwent an emergency right hemicraniectomy with excision and biopsy of the right cerebral hemisphere mass and insertion of a ventriculoperitoneal shunt. At present, she is a 52-month-old child with good speech and minimal left hemiparesis and able to ambulate, with a Functional Independence Measure for Children score of 109. Out of 160 articles screened, there were 10 articles included. A total of 15 patients, including the present case, were analyzed qualitatively. The age at presentation ranged from 30 weeks' gestation to 35 days. Most patients underwent surgical excision (n = 13, 86.7%) and adjuvant chemotherapy (n = 10, 66.7%). The reported range of survival of these patients was from 27 to 110 months. Limited evidence from 15 cases of cGBM suggests that surgical excision and/or chemotherapy may prolong the survival of patients. Therefore, these interventions may be offered and performed to patients with cGBM on a case-by-case basis. Larger clinical studies or registry-based information are necessary to substantiate the implications of our review. [ABSTRACT FROM AUTHOR]

• Blepharospasm is a focal dystonia presenting with orbicularis oculi hyperactivity with varied etiologies. • We report a novel case of thyroid and parathyroid neoplasms that initially presented with blepharospasm. • A work-up for these neoplasms may be warranted for patients with blepharospasm. • Surgical removal of these masses offered a clinically significant control of the blepharospasm in our case. Blepharospasm is a type of focal dystonia depicted by periodic and spontaneous closure of the orbicularis oculi and surrounding muscles. Typical secondary etiologies of blepharospasm may include ophthalmologic and structural brain lesions. In this article, we report a novel case of a patient with a biopsy-proven concurrent papillary carcinoma of the thyroid gland and adenoma of the parathyroid gland with blepharospasm as an exceptionally unique initial manifestation. This report showed that a diagnostic work-up for causes of blepharospasm may include a search for these neoplasm and surgical removal of these masses may offer significant symptomatic control of the focal dystonia. [ABSTRACT FROM AUTHOR]

• Subcutaneous immunoglobulin (SCIg) is an emerging therapeutic option in the management of myasthenia gravis (MG). • Limited evidence from uncontrolled studies showed improvements in functional disability in patients with MG using SCIg. • Common adverse events reported linked to SCIg were headache and injection site reactions. • Clinical trials are still needed to determine the place of this therapy in patients with MG. Subcutaneous immunoglobulin (SCIg) is an emerging therapeutic alternative in the management of myasthenia gravis (MG) due to its potential efficacy, safety, cost effectiveness and ease of administration. At present, there are no systematic reviews that summarized the effects of SCIg in patients with MG. The objective of this study is to determine the efficacy and safety of SCIg in the treatment of adult patients with myasthenia gravis. Relevant records were identified from August 2018 to January 2019 systematic search. Five relevant articles with a total of 34 patients with MG were included in this review. Data on functional disability score and adverse events were obtained. Based on the included uncontrolled studies, the functional disability scores of adult MG patients after SCIg administration showed consistent improvement. Headache and local site injection reactions were the most common adverse events reported. The evidence from limited uncontrolled studies gathered in this review showed that SCIg may improve functional disability in patients with MG. Local and mild adverse events were reported with its administration, but no systemic and serious adverse events were noted. [ABSTRACT FROM AUTHOR]

• Hypokalemic periodic paralysis presenting with prominent bulbar symptoms is rare. • The exact pathophysiology by which hypokalemia causes weakness is unclear. • Hypokalemic periodic paralysis may present with nerve conduction abnormalities. • Bulbar symptoms in hypokalemic paralysis are reversible. • Electrophysiologic abnormalities in hypokalemic paralysis are reversible. Hypokalemic periodic paralysis secondary to distal renal tubular acidosis presenting with prominent bulbar symptoms is extremely rare. The exact pathophysiology by which hypokalemia causes weakness is yet to be elucidated though muscle and nerve membrane hyperpolarization have been hypothesized. The pathophysiology of bulbar involvement in this condition is even more unclear. We report a case presenting as acute flaccid quadriplegia with prominent bulbar symptoms that reversed once potassium levels returned to normal. Serial nerve conduction studies were performed at various potassium levels revealing electrophysiologic abnormalities that corrected with potassium repletion. A systematic review of the literature was also conducted focusing on bulbar symptoms and electrophysiologic findings in hypokalemic periodic paralysis. Nerve conduction abnormalities in this condition are seldom documented, but reports have shown reduced amplitudes of compound motor action potentials and abnormal F-waves during acute attacks of hypokalemic paralysis. [ABSTRACT FROM AUTHOR]

• Acute hemorrhagic leukoencephalitis is a rare and fatal demyelinating disease. • This case presented a patient with an intracerebral hemorrhage in status epilepticus. • Treatment with high-dose methylprednisolone prevented mortality. Acute hemorrhagic leukoencephalitis (AHL) is a rare and mostly fatal fulminant demyelinating disease. This case describes a 63-year old male in status epilepticus associated with an intracerebral hemorrhage following a one week viral prodrome with rapid decline to coma. He exhibited peripheral leukocytosis, neutrophilic pleocytosis with normal glucose and high protein in cerebrospinal fluid (CSF). Additionally, CSF was positive for herpes simplex virus (HSV) polymerase chain reaction (PCR). Medical decompression, low-dose dexamethasone, antibiotics and acyclovir were initially given. Magnetic resonance imaging (MRI) was suggestive of AHL, thus he was treated with methylprednisolone 1 g/day for 5 days. The patient improved and was discharged with significant neurologic morbidity. This is the first reported case of AHL in the Philippines presenting as a diagnostic dilemma with a protracted clinical course who responded to high dose intravenous steroids. [ABSTRACT FROM AUTHOR]

The review assessed the efficacy and tolerability of mitoxantrone in patients with neuromyelitis optica spectrum disorder (NMOSD). Eight articles were reviewed with a total of 117 patients. Annualized relapse rate and progression of disability dramatically decreased post-treatment in most studies. Mitoxantrone was generally tolerated. Only one patient developed acute myeloid leukemia, which lead to septicemia and death. No serious cardiotoxicity was reported. Mitoxantrone may be effective in reducing the frequency of relapse and slowing down the progression of disability in patients with NMOSD. The risk of cardiotoxicity and leukemia detains it as a second-line agent for NMOSD. Unlabelled Image • Mitoxantrone may be effective in reducing the frequency of relapse in NMOSD. • It also slows down the progression of disability in NMOSD. • It is generally safe and tolerable for patients with NMOSD. [ABSTRACT FROM AUTHOR]

Background: While most large studies on the possible association of COVID-19 and stroke were done in high-income countries, only a few studies consisting of small sample populations have been done in low- to middle-income countries like the Philippines.Objectives: To determine the risk factors of stroke among hospitalized COVID19 patients in the Philippines; to determine the possible association between these risk factors and stroke among the same cohort; and to determine if there is an association between mortality and stroke in this same group.Methodology: We obtained relevant clinical and neurological, including stroke data from the Philippine CORONA study, an observational study involving 10,881 patients with COVID-19 admitted in 37 referral hospitals from all over the Philippines.Results: The incidence of stroke among patients with COVID-19 was 3.4% (n = 367). There were more deaths among patients with stroke and COVID-19 than those without stroke and COVID-19 (42.2% vs 14.7%, p < 0.01). In addition, more patients with stroke were admitted in the ICU (43.3% vs 15.0%, p < 0.01) regardless of cause. Smoking (OR: 1.5, 95% CI: 1.3 to 1.7, p < 0.0001), hypertension (OR:1.75, 95% CI:1.53 to 1.97, p < 0.0001), presence of heart failure (OR: 1.4, 95% CI: 1.07 to 1.86, p = 0.01), presence of any neurologic co-morbidities (OR: 1.4, 95% CI:1.11 to 1.46, p = 0.004), and history of stroke (OR:2.3, 95% CI:1.82 to 2.97, p < 0.0001) had direct significant correlation with stroke; while being a health care worker (OR: 0.5, 95% CI: 0.33 to 0.70, p < 0.0004) had an inverse significant association with stroke.Conclusion: COVID-19 stroke patients in the Philippines have a higher mortality and ICU admission rates than patients with COVID-19 alone or COVID-19 stroke patients from developed countries. Our cohort has similar cardiovascular and metabolic risk factors to western patients with stroke, highlighting that COVID-19 may only have a small contribution to stroke incidence. [ABSTRACT FROM AUTHOR]

• A systematic review and meta-analyses were conducted on HDB for MS. • Three RCTs involving 889 patients with MS were analyzed. • HDB was beneficial in terms of ITW25 among PMS (moderate certainty of evidence). • Incidence of any AE were similar between HDB and placebo (high certainty of evidence). • "Laboratory test interference" is increased in HDB (high certainty of evidence). Biotin may activate the acetyl-CoA-, 3-methylcrotonyl-CoA-, propionyl-CoA-, and pyruvate carboxylases to increase myelin repair and/or synthesis, and may enhance the production of adenosine triphosphate (ATP), which may be essential to prevent neurodegeneration. The purpose of this review was to determine the effectiveness and safety of high-dose biotin (HDB) in multiple sclerosis via a systematic review of randomized controlled trials. We searched the following electronic databases for relevant articles: MEDLINE, CENTRAL, EMBASE, Scopus, and ClinicalTrials.gov website until April 2021. We considered randomized clinical trials (RCTs) that involved adult patients diagnosed with any phenotype of multiple sclerosis that conforms with the McDonald 2010/2017 criteria or the Lublin 2014 criteria. We included studies employing high-dose biotin or "MD1003" administered orally for at least 300 mg/day and given for at least three months. The methodological quality assessment of the included studies was done using the Cochrane Risk of Bias (RoB) tool. The GRADE approach was used to assess the certainty of evidence [COE]. Out of 366 records identified, three RCTs involving 889 individuals diagnosed with MS (830 participants had progressive MS (PMS); 59 had RRMS) were pooled for analyses. The overall female:male ratio was 1.16:1. All included trials used HDB as an adjunctive treatment. The risks of bias in the three studies were low across the domains. At 12 to 15 months, there is insufficient evidence that the HDB and placebo arms differed in terms of composite improvement of MS-related disability (relative risk (RR) 2.87; 95% CI 0.29-28.40; 2 trials; 796 participants; I2 = 66%) [low COE], improvement in expanded disability status scale (IEDSS) (RR 2.27; 95% CI 0.25-20.98; 2 trials; 796 participants; I2 = 63%) [low COE], and both IEDSS and improvement in 25-foot walk time (ITW25) (IEDSS-ITW25) (RR 0.58; 95% CI 0.17–2.00; 2 trials; 796 participants; I2 = 13%) [moderate COE] among patients with PMS. Pooled data for ITW25 at 12 to 15 months yielded statistical significance (RR 2.06; 95% CI 1.04-4.09; 2 trials; 796 participants; I2 = 0%) [moderate COE] favoring HDB among patients with PMS. At 12 to 15 months, no significant differences were found in terms of mean change in EDSS (MD -0.06; 95% CI -0.14-0.02; 2 studies; 796 participants; 889 participants; I2 = 68%) among patients with PMS. Synthesized data on incidence of any AEs (RR 0.98; 95% CI 0.92-1.04; 3 trials; I2 = 0%) [high COE] and any serious AEs (RR 0.98; 95% CI 0.77-1.24; 3 trials; 889 participants; I2 = 0%) [moderate COE] were not significantly different between HDB and placebo groups. Out of 662 pooled patients in the HDB group, 31 patients (4.7%) were found to have laboratory test interference compared to zero event in the pooled placebo group [high COE]. A moderate certainty of evidence suggests a potential benefit in favor of HDB administered for 12 to 15 months in terms of ITW25 in patients with PMS. However, an important trade-off of this benefit is the high certainty of evidence suggesting an increased incidence of laboratory test interference when HDB is taken. [ABSTRACT FROM AUTHOR]

Background: Cerebrovascular disease is the second leading cause of death worldwide and provides a heavy burden of disease in Southeast Asia (SEA). Contribution to the collective knowledge of this disease is necessary to address practice and treatment disparities. There is limited data on research productivity in the region. This study aimed to determine research productivity on stroke and other cerebral and spinal vascular diseases among the SEA countries and determine its relationship with bibliometrics, socioeconomic parameters, healthcare delivery indices, and burden of disease.Methods: A comprehensive literature search was conducted using five major healthcare databases. We included studies published until June 2020 on cerebral and spinal vascular disease with at least one author from SEA. Country-specific socioeconomic parameters, the burden of disease, healthcare delivery indices, and the number of neurologists were collected from international databases and published data. Correlational analysis was done on bibliometric indices and collected data.Results: A total of 2577 articles were included. Singapore had the most publications (n=1095, 42.5%) and citations (PlumX n=16,592, 55.2%; Scopus n=22,351, 56.7%). Gross domestic product per capita, percent gross domestic product for research and development, universal health care effective coverage index overall and for stroke treatment, and the number of neurologists had a positive correlation to bibliometric indices.Conclusions: There is a disparity in stroke research productivity among high-income and low-income countries in SEA. Priority must be given to scientific research output and its role in socioeconomic development and policy formulation. [ABSTRACT FROM AUTHOR]

• MS management in the Philippines faces several challenges • There is paucity of epidemiologic data on MS in the Philippines • Very limited disease modifying therapies for MS are available in the Philippine market • Much of diagnostics and therapeutics for MS are not covered by the insurance system • Healthcare provision for MS patients in the Philippines is inadequate The provision of adequate services for individuals living with multiple sclerosis (MS) is an important issue since MS has a chronic and debilitating course. We aimed to review the literature on health service delivery for individuals with MS in the Philippines and identify the gaps in adequate provision of healthcare in these individuals. We reviewed data from relevant local and international repositories on health service delivery for individuals with MS in the Philippines. The epidemiology of MS in the Philippine setting remains unknown. Approximately 1 neurologist caters to 175,000 Filipinos aged 15 and above, and nearly half are practicing in the National Capital Region. Physical access to magnetic resonance imaging is severely limited at 0.8 MRI unit per million Filipinos. Household out-of-pocket payment and voluntary health care payment schemes contributed 53.9% and 12.2%, respectively, to the current health expenditures. The average monthly income of a Filipino household is only 519 USD which may not be enough to cover treatment of a single relapse let alone costly disease-modifying treatments. The Philippines faces challenges in terms of the availability of accurate epidemiologic information, resource allocation, access to services and provision of therapies for individuals with MS. [ABSTRACT FROM AUTHOR]

• MS and NMOSD scientific productivity in the SEA was low in quantity and quality. • Most studies from the SEA were cross-sectional and case reports/series. • Several countries in SEA yielded low scores in the PlumX metrics components. • Thailand, Malaysia, and Singapore produced the greatest number of publications. • % GDP for R&D was correlated with many productivity indices in the MS/NMOSD field. Scientific productivity in the Southeast Asian (SEA) region in the field of multiple sclerosis and neuromyelitis optica spectrum disorder (MS/ NMOSD) was hypothesized to be low in magnitude. The aim of this study was to determine and compare MS/ NMOSD research outputs among the SEA countries in terms of established bibliometric indices. The association between these productivity indices and relevant country-specific socioeconomic factors was also determined. A systematic review was conducted to include all relevant published MS/ NMOSD studies in the SEA indexed in MEDLINE, Embase, Scopus and CENTRAL from the inception of these databases to August 1, 2019. Quantity of research productivity was measured in terms of the total published documents. Quality of research impact was evaluated by assessing the study designs of the published reports, publications in journals with impact factor (IF) and PlumX Metrics (citations, usage, captures, mentions and social medias). Population size, gross domestic product (GDP) per capita, percentage (%) of GDP allocated to research and development (R&D), and the total number of neurologists reported in each country were obtained from reliable published data. Out of 3,547 articles identified, only 142 articles fulfilled the eligibility criteria; therefore, the total number of publications in the SEA region related to MS/ NMOSD was deemed low in quantity. Most studies were cross-sectional and case reports/ series; hence, most studies offered low level of evidence. Since the aggregate scores in citations, usage, captures, mentions, and social medias in PlumX Metrics and publications in journals with IF were low, the overall quality of the published articles was considered low. Thailand (57 articles), Malaysia (40) and Singapore (29) contributed to the majority of publications on the topic-. GDP per capita was statistically correlated with usage. Percent GDP for R&D was positively correlated with total publications, usage, captures and social mediaindices. In conclusion, the scientific impact of MS/ NMOSD in the SEA was considered low in quantity and quality. This study must encourage researchers in the SEA to produce greater volumes of high-quality publications in this particular field and motivate governments to increase % GDP for R&D for the benefit of patients suffering fromthese rare and disabling conditions. [ABSTRACT FROM AUTHOR]