Metachromatic leukodystrophy

White matter diseases, in general, are divided into two categories:

• Dysmyelinating diseases, also known as leukodystrophies, constitute a wide spectrum of cerebral disorders of varying etiologyaetiology.
• Demyelinating diseases involve the destruction of intrinsically normal myelin.

Metachromatic leukodystrophy is a dysmyelinating disease, a rare hereditary disorder, involving three different age groups: infantile, juvenile, and adult. 

Radiographic findings are characterizedcharacterised by bilateral symmetrical confluent areas of signal change in the periventricular white matter and semioval centerscentres. Our case on T2-weighted and FLAIR images show symmetric confluent areas with high signal intensity in the posterior periventricular white matter extending anteriorly and sparing of the subcortical U fibersfibres. The tigroid and leopard skin patterns of demyelination can be seen in the lesions of metachromatic leukodystrophy.  Biochemical abnormal low level of arylsulfatase correlation in peripheral blood leukocytesleucocytes and urine is simple testes for confirmation.