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Washington University Experience | MYELIN (NON-IMMUNE MEDIATED) | Adrenoleukodystrophy (ALD, AMN) | 1A0 Case 1 History
Case1 History ---- The patient was a 47 year old man who had been in good health until 10-12 years prior to admission when adrenal insufficiency was diagnosed and the patient was placed on steroid supplements. In the early 1970's he developed neurologic difficulties including spastic gait ataxia, bilaterally upgoing toes, decreased vibratory sense in the lower extremities, impotence, occasional urinary incontinence and mildly slurred speech. He gave a history at that time of other members of his family having adrenal insufficiency and neurologic disease. His neurologic exam was remarkable for bilateral spasticity, hyperreflexia and an ataxic wide based gait. Toes were upgoing bilaterally. Workup showed normal serum folic acid and B12 levels with normal thyroid function. The patient had a CT scan with contrast which showed multiple ill-defined areas of contrast enhancement in the right parieto-occipital area He was admitted in July 1979 to our hospital with aspiration pneumonia and did not survive.
