Peripheral neuropathy as the sole initial finding in three children with infantile metachromatic leukodystrophy

Eur J Paediatr Neurol. 2009 May;13(3):257-60. doi: 10.1016/j.ejpn.2008.04.011. Epub 2008 Jun 20.

Abstract

Metachromatic leukodystrophy (MLD) is a progressive white matter disease caused by arylsulfatase A deficiency. Demyelination in the nervous system is detected by cerebral magnetic resonance imaging (MRI) and neurophysiological studies. We present three children with infantile MLD, who had difficulties in standing and walking with absent reflexes. Protein levels in cerebral spinal fluid (CSF) were elevated and nerve conduction studies revealed slowing down of motor nerve conduction velocity. Initial cerebral MRIs showed no white matter changes. Consecutively, all three children developed clinical symptoms of neurodegenerative disease. Follow-up MRI and arylsulfatase A testing led to diagnosis of MLD. We conclude, that in young children who present with an acute/subacute demyelinating polyneuropathy, MLD is a differential diagnosis.

Publication types

  • Case Reports

MeSH terms

  • Demyelinating Diseases / diagnosis
  • Demyelinating Diseases / physiopathology*
  • Diagnosis, Differential
  • Female
  • Humans
  • Infant
  • Leukodystrophy, Metachromatic / complications
  • Leukodystrophy, Metachromatic / diagnosis*
  • Leukodystrophy, Metachromatic / pathology
  • Leukodystrophy, Metachromatic / physiopathology*
  • Magnetic Resonance Imaging
  • Male
  • Muscle Weakness / etiology
  • Muscle Weakness / physiopathology*
  • Neural Conduction*
  • Peripheral Nervous System Diseases / diagnosis
  • Peripheral Nervous System Diseases / etiology
  • Peripheral Nervous System Diseases / physiopathology*