What is Leukodystrophy?

Mary McMahon

Leukodystrophy is an umbrella term which refers to a family of genetic conditions which all involve myelin, a fat which sheathes nerve cells. The term, derived from the Greek, means “ill growth of white matter.” In patients with leukodystrophy, myelin becomes degraded or fails to grow properly, and the patient develops nervous system disorders. Leukodystrophies can be characterized as central or peripheral, depending on the part of the nervous system involved, and they can be very serious.

Couples who have experienced multiple miscarriages may want to research whether they are carrying genes which are incompatible with life.
Couples who have experienced multiple miscarriages may want to research whether they are carrying genes which are incompatible with life.

Some leukodystrophies include: Canavan disease, childhood ataxia with central nervous system hypomyelination, Alexander disease, Refsum disease, Pelizaeus-Merzbacher disease, metachromatic leukodystrophy, cerebroteninous xanthomatosis, and adrenoleukodystrophy. Some conditions appear to be linked to ethnic inheritance, as with metachromatic leukodystrophy and adrenoleukodystrophy in people of Scandinavian heritage and Canavan disease is Ashkenazi Jews, while others appear spontaneously in many different populations.

Leukodystrophy may cause deafness.
Leukodystrophy may cause deafness.

People with leukodystrophy lack enzymes which help the body regulate myelin. In some cases, this means that myelin becomes degraded or is not built properly by the body, while in other instances, the body may be slow to grow myelin, which means that as it is broken down, it is not replaced. Typically, patients start out healthy, and experience a slow neurological decline which leads them to pursue treatment with a neurologist who can diagnose leukodystrophy after conducting some diagnostic tests. Leukodystrophy commonly emerges in infants and young children.

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Symptoms of leukodystrophy may include difficulty swallowing.
Symptoms of leukodystrophy may include difficulty swallowing.

Symptoms of leukodystrophy can vary, depending on the condition a patient has, but they can include difficulty eating or swallowing, a staggering gait, poor coordination, confusion, and tremors. Some forms cause blindness, deafness, and other issues as they progress. Like other genetic disorders, leukodystrophy cannot be cured, because it involves a fundamental error in the DNA of the patient, but it can be managed. Taking steps early can improve quality of life for the patient and improve patient comfort.

People in populations associated with genetic disorders, including leukodystrophies, may want to consider getting genetic testing to see if they carry dangerous genes. Genetic counseling is especially advisable for people who want to have children, as advance genetic testing may help parents make informed decisions, and could help parents avoid the conception of a child who has a severe genetic disorder like leukodystrophy. Couples who have experienced repeated trouble conceiving or multiple miscarriages may also want to explore genetic testing options to see if they are carrying genes which result in birth defects which are incompatible with life.

Leukodystrophy commonly emerges in infants and young children.
Leukodystrophy commonly emerges in infants and young children.

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Discussion Comments

dfoster85

@MrsWinslow - "Incompatible with life" is a medical term that applies to very serious conditions. I know that sometimes a few people with these conditions may live a relatively long time (the oldest person with Trisomy 18, for instance, lived into her 40s), but these conditions are usually fatal in infancy or childhood if not before birth.

I'm not sure if all the forms of leukodystrophy are incompatible with life, or just the more serious ones. I'm thinking that some are not; I know Stephen Hawking has some form of this and he's obviously still going! Maybe by "managed," the author just meant that the symptoms could be alleviated.

I remember watching "Lorenzo's Oil" during a genetics class I took at a summer enrichment program when I was in school. The kid did have some kind of dystrophy, as I recall. I also remember learning about Duchenne muscular dystrophy, which causes painful shortening of the muscles. One family didn't realize they were passing on the gene until they'd had several boys. Then they were all in different stages of the disease.

MrsWinslow

I'm a little confused. The article says that the disease can be "managed" even though it can't be cured, but then it uses the rather sinister phrase "incompatible with life." Are all forms of leukodystrophy fatal? (Meaning, I suppose, do they always drastically shorten the victim's lifespan.)

"Myelin" sounds familiar. Did the kid in "Lorenzo's Oil" have a form of leukodystrophy?

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