Multiple Sclerosis (MS): This is the most common cause of central demyelination, leading to a wide range of neurological symptoms including paresthesias in all four limbs. MS is characterized by its relapsing-remitting course, although it can also present in a progressive form.

Neuromyelitis Optica (NMO): Also known as Devic's disease, NMO is an autoimmune inflammatory condition that predominantly affects the optic nerves and spinal cord, leading to symptoms like paresthesias, vision loss, and weakness. It is more severe than MS and has a distinct antibody marker (AQP4).
Acute Disseminated Encephalomyelitis (ADEM): ADEM is a monophasic illness characterized by widespread demyelination in the brain and spinal cord, often following a viral infection or vaccination. It presents with rapid onset of neurological symptoms, including paresthesias, which can be severe.
Subacute Combined Degeneration (SCD) due to Vitamin B12 Deficiency: This condition affects the dorsal and lateral columns of the spinal cord, leading to demyelination. Symptoms include paresthesias in the limbs, weakness, and gait disturbances. It's a treatable cause of central demyelination.

Spinal Cord Compression: This is a medical emergency that can cause rapid progression of neurological symptoms, including paresthesias, weakness, and loss of bladder and bowel control. Causes include tumors, abscesses, and herniated discs.
Cervical Spondylotic Myelopathy (CSM): A condition caused by degenerative changes in the cervical spine, leading to compression of the spinal cord. Symptoms can include paresthesias, weakness, and gait difficulties.
Transverse Myelitis: An inflammatory condition that affects a segment of the spinal cord, leading to symptoms like paresthesias, weakness, and autonomic dysfunction. It can be a standalone condition or part of a larger syndrome like MS or NMO.

Leukodystrophies: A group of rare, genetic disorders characterized by progressive degeneration of the white matter in the brain, leading to central demyelination. Examples include Adrenoleukodystrophy and Metachromatic Leukodystrophy.
Central Pontine Myelinolysis (CPM): A rare condition characterized by demyelination in the pons area of the brainstem, often associated with rapid correction of hyponatremia. It can lead to "locked-in syndrome" or other severe neurological deficits.
Tumefactive Demyelinating Lesions: These are rare, large demyelinating lesions that can mimic brain tumors on imaging. They can cause a variety of neurological symptoms, including paresthesias, depending on their location.