Adrenomyeloneuropathy, a dynamic progressive disorder: brain magnetic resonance imaging of two cases

Adrenomyeloneuropathy (AMN) is a phenotype variant of X-linked adrenoleukodystrophy. We present two patients with adult-onset AMN who were initially suspected to have demyelinating disorders radiologically and finally diagnosed on the basis of laboratory data. The brain magnetic resonance images showed abnormal signal intensity at pyramidal tracts and cerebellar hemisphere bilaterally with abnormal enhancement after contrast medium administration. Review of the literature shows that the brain magnetic resonance findings of adrenomyeloneuropathy may include normal brain, tract demyelination, white matter demyelination, or brain atrophy. Disease progression was demonstrated by follow-up imaging.