Symptoms can vary within the types of ALD.
X-linked ALD (Childhood Cerebral ALD)
This form is the most severe. It only affects boys. Symptoms usually begin between 2–10 years of age. About 35% of patients can have severe symptoms during the early phase. On average, death results in two years. Some patients may live a couple of decades.
Initial symptoms include:
- Behavioral changes
- Poor memory
- Vision loss
- Hearing loss
- Difficulty swallowing and speaking
- Difficulty with walking and coordination
- Increased pigmentation (“bronzing”) of the skin, due to adrenal hormone deficiency ( Addison’s disease )
- Progressive dementia
- Vegetative state or death
X-linked ALD (Adolescent Cerebral ALD)
This type is similar to the childhood type. In this type it begins around 11-21 years of age. The progression is usually slower.
This is the most common form. Symptoms of AMN can present in the 20s. It progresses slowly. They can include:
X-linked ALD (Adult Cerebral ALD)
With this type, symptoms usually do not appear until young adulthood (20s) or middle age (50s). It causes symptoms similar to schizophrenia and dementia . It usually progresses fast. Death or a vegetative state can occur in 3-4 years.
This form is only seen in women. Symptoms may be mild or severe. It usually does not affect the adrenal gland function.
The doctor will ask about symptoms and medical history. A physical exam will be done. The doctor may suspect ALD from its symptoms. To confirm the diagnosis your doctor may order:
- Blood tests—to look for increased amount of very long chain fatty acids
- MRI scan of the brain —may be done to look for brain involvement