Which CNS disease is characterized by damage to the myelin sheath and plaques in the brain and spinal cord, leading to tremor, weakness, incoordination, paresthesia, and disturbances in vision and speech?

• A. Headache
• B. Epilepsy
• C. Parkinson's disease
• D. Multiple Sclerosis

Answer: (D)

Damage to the myelin sheath in the central nervous system with plaques (sclerosis) in the brain and spinal cord describes multiple sclerosis. Myelin normally insulates nerve fibers and speeds electrical conduction; when it’s damaged, signals slow or fail, and the effects show up in various parts of the CNS depending on where lesions occur. The combination of tremor, weakness, incoordination, sensory changes like paresthesias, and disturbances in vision and speech reflects lesions in diverse CNS pathways, which is characteristic of MS’s disseminated demyelinating process. This autoimmune attack leads to demyelination and scar formation (plaques), producing a wide, fluctuating array of neurologic symptoms over time. In contrast, headaches, epilepsy, and Parkinson’s disease involve different mechanisms and symptoms that don’t center on widespread CNS demyelination with plaques.