These include inflammatory conditions such as multiple sclerosis (MS), neuromyelitis optica spectrum disorders (NMOSD), acute disseminated encephalomyelitis (ADEM), the clinically isolated syndrome (CIS), myelin oligodendrocyte glycoprotein associated disorders (MOGAD), glial fibrillary acidic protein astrocytopathy (GFAP), in addition, compressive, neoplastic, vascular, metabolic, or infectious etiology are also need to be ruled out [2]. The gene discussed is GFAP; the disease is Down syndrome.