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Disorders of White Matter Tracts: What Classroom Teachers Should Know About Multiple Sclerosis

School is the primary source of information; this makes teachers a human resource to inform students. Therefore, teachers should be well-equipped with information about diseases that affect people in the community, which students have frequently raised questions about. This educative paper targets teachers to better prepare them with relevant information about multiple sclerosis. The information will help reverse the negative belief about the disease and help with early detection of the disease. Understanding multiple sclerosis requires brief knowledge of the structural function of the central nervous system. The human central nervous system is composed of the brain and the spinal cord, which are interconnected to other body structures by nerves. Multiple sclerosis is an auto-mediated inflammatory disease of the central nervous system (Lassmann, 2018). The disease is described as auto-mediated or autoimmune because the body’s white blood cells attack and destroy the central nervous system.

Pathophysiology of multiple sclerosis

The exact etiology of multiple sclerosis is unknown, but several studies have linked the disease to the autoimmune attack of the central nervous system. The autoimmune action of T-cells against the CNS destroys the axon, oligodendrocytes, glial and associated structures involved in impulse transmission (Dobson & Giovannoni, 2019). The autoimmune attack of axons causes loss or degeneration of the myelin sheath, a fatty layer that covers the axon. Demyelination of the axons renders them ineffective in transmitting impulses. Also, the destruction causes inflammation and scarring of the affected structures. The scarring or scar tissue formation is a result of the healing process. Demyelination and destruction of the central nervous system are associated with specific symptoms. The affected person may present with clinical signs that indicate significant damage or malfunction of the central nervous system. The symptoms are due to the effect of the disease on the brain, spinal cord, and optic nerves of the eyes. There are risk factors associated with the disease. These include environmental factors, genetics, and familial risks. Environmental factors such as smoking, childhood obesity, and exposure to the Epstein-Barr virus are modifiable, unlike genetics and familial factors.

Signs and symptoms of multiple sclerosis

Symptoms of multiple sclerosis depend on the affected region. Destruction of the optic nerve is associated with symptoms of optic neuritis. The optic nerve innervates the eyes. Damage to the optic nerve disrupts the connection of nerves that supply the eyes (Lassmann, 2018). The person may report gradual loss of vision in one or both eyes. The loss of vision may start with blurred vision, nystagmus, oscillopsia, or diplopia. The person may report double vision, seeing double objects, or overlapping images. Motor problems are also associated with the disease. The person may show weakness of the extremities, problems with gait, balance problems, and spasticity. The general weakness of the upper and lower extremities may impair the person’s activity levels. The person may also show signs of elimination dysfunction such as incontinence, retention, and constipation. The body muscles are highly innervated to enhance coordination. Destruction of nerves impairs the relaxation and contraction of sphincter muscles of the bladder and rectum. Affected persons may report sensory problems such as Lhermitte’s signs and numbness. The Lhermitte’s sign is a symptom whereby a neck flexion is associated with an electrical-like shooting sensation extending down the back or into the upper limbs (McGinley, Goldschmidt & Rae-Grant, 2021). Changes in cognition are also common. The affected persons may exhibit changes in concentration, memory, mood, and information speed processing.

Diagnosis and investigations

A combination of clinical procedures and assessments can help to confirm the presence of multiple sclerosis. Magnetic imaging resonance (MRI) is the most common method used to confirm multiple sclerosis. MRI is a technology involving the use of a powerful magnetic field, radio waves, and displays screen to view the affected axons and associated structures. Analysis of the cerebrospinal fluid is recommended to support the MRI. Persons with multiple sclerosis have elevated IgA in the spinal fluid (McGinley, Goldschmidt & Rae-Grant, 2021). Analysis of the spinal fluid specimen may reveal oligoclonal bands.


The prevalence of multiple sclerosis is approximately 100 per 100000 persons. In addition, approximately 2.5 million people are living with multiple sclerosis (Lassmann, 2018). Most people with the disease are reported to live away from the equator. The distribution of people with multiple sclerosis is affected by the equator. The disease is more prevalent in densely populated countries of the Nordic regions. Studies involving tracking individuals from high-risk areas show that the risk for multiple sclerosis reduces when the individuals move in low-risk areas. Persons with multiple sclerosis have a short lifespan of between two to seven years following the detection of the disease.

Prevention and treatment

There is no cure or preventive options for multiple sclerosis. Patients with the disease need support therapies, lifestyle modification, and symptomatic management. Genetic counseling is appropriate for families with high risks. According to Dobson & Giovannoni (2019), monozygotic twins are 20-40 folds likely to develop the disease. Physiotherapy is indicated for the patients to manage muscle spasticity and prevent other motor deficiencies. There are also medications approved and effective in the management of relapses.


Dobson, R., & Giovannoni, G. (2019). Multiple sclerosis–a review. European journal of neurology26(1), 27-40.

Lassmann, H. (2018). Multiple sclerosis pathology. Cold Spring Harbor perspectives in medicine8(3), a028936.

McGinley, M. P., Goldschmidt, C. H., & Rae-Grant, A. D. (2021). Diagnosis and treatment of multiple sclerosis: a review. Jama325(8), 765-779.


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