Differential diagnosis of leukoencephalopathy

 

Toxins:

- Antineoplastic agents (cranial irradiation, methotrexate, carmustine, cisplatin, cytarabine, fluorouracil, levamisole, fludarabine, thiotepa, interleukin-2, interferon alfa),

- immunosuppressive drugs (cyclosporine, tacrolimus)

- antimicrobial agents (amphotericin B, hexachlorophene)

- drugs of abuse (toluene, ethanol, cocaine, 3,4-methylenedioxymethamphetamine, intravenous heroin, inhaled “heroin” pyrolysate, psilocybin)

- environmental toxins (carbon monoxide, arsenic, carbon tetrachloride

 

Genetic: 

- Leukodystrophies (e.g., metachromatic leukodystrophy, Krabbe’s disease, adrenoleukodystrophy, Pelizaeus–Merzbacher disease),

- Aminoacidurias (e.g., phenylketonuria, maple syrup urine disease) 

 

Demyelinating disease:

- Multiple sclerosis

- acute disseminated encephalomyelitis (ADEM)

- acute hemorrhagic encephalomyelitis

- Schilder’s disease

- Marburg disease

- Baló’s disease (concentric sclerosis) 

 

Infection:

- Acquired immunodeficiency syndrome dementia complex

- Progressive multifocal leukoencephalopathy

- Subacute sclerosing panencephalitis

- Progressive rubella panencephalitis

- Varicella–zoster encephalitis

- Cytomegalovirus encephalitis

- Lyme encephalopathy 

 

Metabolic disorder:

- Cobalamin deficiency

- Folate deficiency

- Hypoxia

- Eclampsia

- High-altitude cerebral edema 

 

 Vascular disorder:

- Binswanger’s disease

- Hypertensive encephalopathy

- Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL)

- Cerebral amyloid angiopathy (CAA)

 

Trauma:

- Diffuse axonal injury secondary to traumatic brain injury

 

Hydrocephalus:

- Early hydrocephalus,

- Normal-pressure hydrocephalus