: Leukodystrophies are a group of rare neurodegenerative disorders, usually presenting in infancy with a variable combination of cognitive, motor, and coordination impairment. Adult-onset cases are even more rare, often representing a diagnostic challenge even for experienced neurologists. Here, we present a case of a 44-year-old man with subacute and rapidly progressive spastic paraplegia, whose brain MRI revealed white matter abnormalities compatible with a diagnosis of leukodystrophy. We discuss how to apply a simplified diagnostic algorithm to distinguish acquired leukoencephalopathies from leukodystrophies and how to delve into the maze of genetic testing for white matter diseases. In our patient, we reached the diagnosis of a treatable disorder, whose early recognition is essential to prevent severe neurologic deterioration.

Rossi, S., Concolino, P., Di Natale, D., Pasquetti, D., Di Lella, G. M., Chiurazzi, P., Silvestri, G., Clinical Reasoning: A Young Man With Subacute Onset of Spastic Paraparesis, <<NEUROLOGY>>, 2023; 100 (4): 199-205. [doi:10.1212/WNL.0000000000201516] [https://hdl.handle.net/10807/227232]

Clinical Reasoning: A Young Man With Subacute Onset of Spastic Paraparesis

Rossi, Salvatore;Concolino, Paola;Di Natale, Daniele;Pasquetti, Domizia;Di Lella, Giuseppe Maria;Chiurazzi, Pietro;Silvestri, Gabriella
2023

Abstract

: Leukodystrophies are a group of rare neurodegenerative disorders, usually presenting in infancy with a variable combination of cognitive, motor, and coordination impairment. Adult-onset cases are even more rare, often representing a diagnostic challenge even for experienced neurologists. Here, we present a case of a 44-year-old man with subacute and rapidly progressive spastic paraplegia, whose brain MRI revealed white matter abnormalities compatible with a diagnosis of leukodystrophy. We discuss how to apply a simplified diagnostic algorithm to distinguish acquired leukoencephalopathies from leukodystrophies and how to delve into the maze of genetic testing for white matter diseases. In our patient, we reached the diagnosis of a treatable disorder, whose early recognition is essential to prevent severe neurologic deterioration.
2023
Inglese
Rossi, S., Concolino, P., Di Natale, D., Pasquetti, D., Di Lella, G. M., Chiurazzi, P., Silvestri, G., Clinical Reasoning: A Young Man With Subacute Onset of Spastic Paraparesis, <<NEUROLOGY>>, 2023; 100 (4): 199-205. [doi:10.1212/WNL.0000000000201516] [https://hdl.handle.net/10807/227232]
File in questo prodotto:
Non ci sono file associati a questo prodotto.

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10807/227232
Citazioni
  • ???jsp.display-item.citation.pmc??? 1
  • Scopus ND
  • ???jsp.display-item.citation.isi??? ND
social impact