Inclusions in the sural nerve in metachromatic leukodystrophy

A 2 year old girl develops a fever, anorexia and a cough which last three weeks. Following this event, she presented with intention tremor and increasing difficulty with crawling. At the age of 3, a nerve biopsy was done which made the diagnosis of metachromatic leukodystrophy. EM examination of the nerve biopsy revealed large quantitites of abnormal structures in the cytoplasm of Schwann and phagocytic cells. Virus like spheroid bodies were present in a few axons and cytoplasm of Schwann cells.