Fact-sheet: Alexander Disease
Updated on 08/17/2020 at 3:29 PM
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Definition
Dysmyelinating leukodystrophy.
The involvement is predominantly subcortical.
Demyelination begins in the frontal regions and progresses posteriorly toward the temporal and parietal regions with involvement of the U-fibers.
Clinical features
In children, during prepuberty and puberty:
- Psychomotor delay and spastic quadriplegia.
- Progressive megalencephaly.
In adults:
- Progressive extrapyramidal syndrome with bulbar involvement and optic atrophy.
CT
- Hypodensity of the white matter.
MRI
Subcortical involvement.
T1: hypointense white matter.
T2: white matter hyperintensity in the frontal region extending to the parietal and temporal regions, then to the external capsules with involvement of the subcortical U-fibers.
Gadolinium injection: possible enhancement.
Management
- Multidisciplinary management