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Head trauma can initiate the onset of adreno-leukodystrophy.
[adrenomyeloneuropathy]
X-
linked
adreno-
leukodystrophy
and
its
adult
variant
,
adrenomyeloneuropathy
,
are
caused
by
mutations
in
ABCD
1
that
encodes
a
peroxisomal
membrane
protein
of
unknown
physiological
significance
.
In
spite
of
identical
mutations
,
they
can
have
markedly
divergent
neurological
and
neuropathologic
characteristics
.
Adreno-
leukodystrophy
classically
presents
in
normal
boys
with
mild
neuropsychiatric
features
,
which
progress
to
frank
neurological
signs
,
the
vegetative
state
and
death
in
approximately
three
years
.
Adrenomyeloneuropathy
typically
affects
young
men
with
spastic
paraparesis
and
sensory
ataxia
that
can
progress
over
decades
.
The
neuropathologic
correlate
for
adreno-
leukodystrophy
is
severe
inflammatory
demyelination
of
posterior
cerebral
white
matter
,
while
a
chronic
distal
axonopathy
of
spinal
cord
and
peripheral
nerve
occurs
in
adrenomyeloneuropathy
.
Consequently
,
both
modifier
genes
and
environmental
factors
have
been
implicated
in
their
pathogeneses
.
We
report
five
cases
of
adreno-
leukodystrophy
whose
onsets
were
initiated
by
moderate
to
severe
head
trauma
,
two
of
whom
were
conversions
from
adrenomyeloneuropathy
.
Their
clinical
courses
were
rapidly
incapacitating
,
short
(
i
.
e
.
,
weeks
to
a
few
years
)
and
fatal
due
to
marked
cerebral
inflammatory
demyelination
.
These
cases
,
in
concert
with
several
previous
reports
,
indicate
that
head
trauma
is
one
environmental
factor
that
can
have
a
profoundly
deleterious
effect
on
those
genetically
at
risk
for
,
or
with
milder
clinical
phenotypes
of
,
this
disease
.
Avoidance
of
potential
head
trauma
and
a
rapid
response
to
episodes
of
moderate
to
severe
head
trauma
in
this
patient
population
seem
prudent
.
Diseases
Validation
Diseases presenting
"leukodystrophy"
symptom
achondroplasia
adrenomyeloneuropathy
alexander disease
cadasil
canavan disease
carcinoma of the gallbladder
classical phenylketonuria
coats disease
fabry disease
gm1 gangliosidosis
krabbe disease
neonatal adrenoleukodystrophy
phenylketonuria
pyruvate dehydrogenase deficiency
wiskott-aldrich syndrome
x-linked adrenoleukodystrophy
zellweger syndrome
This symptom has already been validated