Cyclic mood disorder heralding adult-onset autosomal dominant leucodystrophy: a clinical masquerader.

[alexander disease]

Leucodystrophies are a heterogeneous group of progressive white matter diseases which may be inherited in dominant , recessive or X-linked fashion depending on the type . Adrenoleucodystrophy (ALD ) and metachromatic leucodystrophy (MLD ) are rather commoner forms of leucodystrophies whereas krabbes disease , alexander disease , cannavans disease etc . are of less common type . Adult-onset autosomal dominant leucodystrophy (ADLD ) is a lately described rarer form of leucodystrophy with perhaps no case report from India . Various leucodystrophies may have different clinical presentations , ranging from subtle cognitive and psychiatric manifestations to gross motor disabilities , visual impairment and seizure . Psychiatric manifestations in the form of psychoses and frank schizophrenia are commonly described in MLD . Depression though uncommonly reported in MLD , cyclic mood disorders have been rarely described in any form of leucodystrophies . We are reporting an eye opener , a case of ADLD which masqueraded as a rapid cyclic mood disorder for initial four years , later to be followed by progressive neurological signs and symptoms . To the best of our knowledge , this is perhaps the first case report of ADLD presenting as rapid cyclic mood disorder in the world literature .