Juvenile Metachromatic Leukodystrophy Mimicking Relapsing-Remitting Multiple Sclerosis

Some cases of late-onset metachromatic leukodystrophy (MLD), which typically presents as a peripheral neuropathy, may present as a rapidly progressive central nervous system demyelinating disorder. This case report describes an important diagnostic and treatment dilemma: Are multiple sclerosis and MLD really two diseases, and should MLD be considered and treated as an autoimmune disorder?