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Value of Computed Tomographic Scanning and Magnetic Resonance Imaging of the Brain

Gary Waltz, MD; Sami I. Harik, MD; Benjamin Kaufman, MD

Arch Neurol. 1987;44(2):225-227.

Abstract
• Patients with adult-onset metachromatic leukodystrophy (MLD) often present with personality changes or deterioration of cognitive functions. Although rare, this form of MLD should be included in the differential diagnosis of psychotic and dementing disorders. The following case report describes a 38-year-old man with adult-onset MLD, who carried the diagnosis of schizophrenia and was treated as a schizophrenic for a number of years. Metachromatic leukodystrophy was initially suspected because of white matter abnormalities detected on computed tomographic scans and magnetic resonance images of the brain. The diagnosis of MLD was confirmed by the discovery of markedly reduced leukocyte arylsulfatase A activity. The computed tomographic and magnetic resonance imaging findings in MLD are reviewed.

Author Affiliations
From the Departments of Psychiatry (Dr Waltz), Neurology (Dr Harik), and Radiology (Dr Kaufman), University Hospitals of Cleveland and Case Western Reserve University School of Medicine, Cleveland.

Footnotes
Accepted for publication Sept 2, 1986.

Reprint requests to Department of Neurology, University Hospitals of Cleveland, Cleveland, OH 44106 (Dr Harik).

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