Case definition and classification of leukodystrophies and leukoencephalopathies

An approved definition of the term leukodystrophy does not currently exist. The lack of a precise case definition hampers efforts to study the epidemiology and the relevance of genetic white matter disorders to public health. Thirteen experts at multiple institutions participated in iterative consensus building surveys to achieve definition and classification of disorders as leukodystrophies using a modified Delphi approach. A case definition for the leukodystrophies was achieved, and a total of 30 disorders were classified under this definition. In addition, a separate set of disorders with heritable white matter abnormalities but not meeting criteria for leukodystrophy, due to presumed primary neuronal involvement and prominent systemic manifestations, was classified as genetic leukoencephalopathies (gLE). A case definition of leukodystrophies and classification of heritable white matter disorders will permit more detailed epidemiologic studies of these disorders. •Leukodystrophies are a heterogeneous group of disorders with variable clinical manifestations and pathologic mechanisms•Lack of a precise definition for leukodystrophies hampers efforts to study the epidemiology and the relevance to public health•A consensus definition was achieved, based on the specific involvement of the white matter of the central nervous system•30 distinct disorders were defined as leukodystrophies based on the proposed definition•A class of genetic leukoencephalopathies was characterized that may or may not include leukodystrophies