Leukoencephalopathy with swelling and a discrepantly mild clinical course in eight children

M. S. van der Knaap*, P. G. Barth, H. Stroink, O. van Nieuwenhuizen, W. F.M. Arts, F. Hoogenraad, J. Valk

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


An identical syndrome of cerebral leukoencephalopathy and megalencephaly with infantile onset was discovered in 8 children, including 2 siblings. Neurological findings were initially normal or near normal, despite megalencephaly and magnetic resonance imaging (MRI) evidence of severe white matter affection. Slowly progressive ataxia and spasticity developed, while intellectual functioning was preserved for years after onset of the disorder. MRI characteristics included diffuse abnormality in signal intensity and swelling of the cerebral hemispheral white matter with cyst‐like spaces in the frontoparietal and anterior‐temporal subcortical areas. MR spectra were relatively mildly abnormal. Screening for inborn errors, especially those that cause either megalencephaly or white matter disease or both was negative. A distinguishing feature of the present disorder is the apparently severe abnormality of the cerebral white matter as demonstrated by MRI, which contrasts with the remarkably slow course of functional deterioration.

Original languageEnglish
Pages (from-to)324-334
Number of pages11
JournalAnnals of Neurology
Issue number3
Publication statusPublished - Mar 1995

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