Diagnosis

Your doctor will perform a physical examination and review your symptoms and medical history and check for signs of metachromatic leukodystrophy.

Your doctor may order tests to diagnose your condition. These tests also help determine how severe your condition is.

  • Blood and urine tests. Blood tests look for an enzyme deficiency that causes metachromatic leukodystrophy.

    You may also have urine tests to check for buildup of fatty substances (lipids).

  • Genetic tests. Your doctor will conduct genetic tests for mutations in the gene associated with metachromatic leukodystrophy.

    He or she may also recommend testing family members, particularly women who are pregnant (prenatal testing) for mutations in the gene.

  • Nerve conduction study. This test measures electrical nerve impulses and function in your muscles and nerves by passing a small current through electrodes on your skin.

    Your doctor may use this test to look for nerve damage (peripheral neuropathy), which is common in people with metachromatic leukodystrophy.

  • Magnetic resonance imaging (MRI). This test uses powerful magnets and radio waves to produce detailed pictures of your brain.

    Your doctor may use this test to determine if you have signs of metachromatic leukodystrophy, which has a characteristic striped pattern (tigroid) of abnormal white matter (leukodystrophy) in your brain.

  • Psychological and cognitive tests. Your doctor may test your psychological and thinking (cognitive) abilities. These tests may help determine how the condition affects your brain function.

Treatment

Metachromatic leukodystrophy can't be cured, and there are few treatment options. But, your doctors will work with you to help manage your signs and symptoms and try to improve your quality of life. Ask Talk to your doctor about the possibility of participating in a clinical trial.

Metachromatic leukodystrophy can be managed with several treatments:

  • Medications. Medications may reduce your signs and symptoms and relieve your pain.
  • Stem cell transplant. Hematopoietic stem cell transplants sometimes have slowed the progression of metachromatic leukodystrophy by introducing healthy cells to help replace diseased ones.
  • Physical, occupational and speech therapy. You may have physical therapy to promote muscle and joint flexibility and maintain your range of motion as much as possible. You may need a wheelchair, walker or other assistive devices as your condition progresses.

    You may have occupational and speech therapy to improve your quality of life.

  • Nutritional assistance. You and your family may work with a nutrition specialist (dietitian) to make sure you're getting the right nutrition. Eventually, it may become difficult to swallow food or liquid.

    You may need assistive feeding devices as your condition progresses.

Potential future treatments

There are some potential metachromatic leukodystrophy treatments currently in research. These include gene therapy and other types of cell therapy that introduce healthy genes to replace diseased ones.

Metachromatic leukodystrophy care at Mayo Clinic

Nov. 23, 2016
References
  1. NINDS metachromatic leukodystrophy information page. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/metachromatic_leukodystrophy/metachromatic_leukodystrophy.htm. Accessed Sept. 8, 2016.
  2. Cruse RP. Metachromatic leukodystrophy. http://www.uptodate.com/home. Accessed Sept. 8, 2016.
  3. Patil SA, et al. Developing therapeutic approaches for metachromatic leukodystrophy. Drug Design, Development and Therapy. 2013;7:729.
  4. Pagon RA, et al., eds. Arylsulfatase A Deficiency. In: GeneReviews. Seattle, Wash.: University of Seattle, Washington; 1993-2016. http://www.ncbi.nlm.nih.gov/books/NBK1116. Accessed Sept. 8, 2016.
  5. Neurological diagnostic tests and procedures. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/misc/diagnostic_tests.htm. Accessed Sept. 8, 2016.
  6. Patterson MC (expert opinion). Mayo Clinic, Rochester, Minn. September 13, 2016.