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What Is White Matter?
The white matter of the CNS appears white when viewed microscopically after preparation with some stains.
By contrast, the gray matter appears gray when viewed microscopically after some types of staining.
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Gray matter is located on the outer regions of the brain and the central areas of the spinal cord.
Types of White Matter Disease
There are many different white matter diseases.
The symptoms corresponded to the affected areas of CNS involvement.
Many nerve pathways travel throughout the white matter in the CNS.
So, relatively small areas of white matter disease can cause substantial weakness or sensory changes.
Extensive white matter disease can also cause nonspecific symptoms, such as dementia and vision changes.
Rather, they each produce a pattern of symptoms that are characteristic of that particular disease.
Diagnostic testing may include:
Treatment
Some white matter diseases can be reversed or controlled with treatment.
However, some white matter diseases can only be treated symptomatically.
These treatments are used for MS exacerbations and ADEM.
Additionally, MS is also treated withdisease-modifying therapy (DMT), which helps prevent exacerbations.
Vascular dementia is because of an accumulation of small-vessel strokes that cause extensive white matter damage.
Prognosis
The prognosis of white matter disease varies.
MS is not a fatal disease.
By managing the MS and co-occurring conditions,life expectancymay be only slightly shorter.
Most infectious causes of white matter disease can be treated with medication, resulting in improvement and good survival.
However, HIV encephalopathy and PML are associated with a very poor prognosis and short life expectancy.
Summary
White matter diseases affect the white matter in the CNS.
Some white matter diseases only involve white matter, such as MS.
Some white matter diseases can also involve other parts of the CNS.
Theres a wide range of white matter diseases.
The timing, causes, symptoms, and treatments vary.
Some white matter diseases can be treated effectively, but others are permanent, such as vascular dementia.
2021;12:632535. doi:10.3389/fneur.2021.632535
British Heart Foundation.Vascular dementia: your questions answered.
