Sp. Wilson et al., ROSENTHAL FIBER ENCEPHALOPATHY PRESENTING WITH DEMYELINATION AND ROSENTHAL FIBERS IN A SOLVENT ABUSER - ADULT ALEXANDERS-DISEASE, Clinical neuropathology, 15(1), 1996, pp. 13-16
We report a neuropathological case of the brain of a 22-year-old male
solvent abuser. He had also been diagnosed as suffering from schizophr
enia. Neurohistology revealed the presence of Rosenthal fibers (RFs) i
n subpial and perivascular collections in the medulla, the floor of th
e 3rd and 4th ventricles, and also in the spinal cord. There was mild
demyelination in the frontal, temporal, and parietal lobes, as well as
the left dorsal column in the spinal cord. There was bilateral basal
ganglia calcification. Demyelination and RFs have been the hallmark of
the diagnosis of adult Alexander's disease. We urge that these are in
sufficient criteria for this nosological category, and suggest the alt
ernative and more appropriate label of Rosenthal fiber encephalopathy.
In view of the known toxic, clinical effects of chronic solvent abuse
, and the lack of knowledge of the neuropathological effects, we also
tentatively note the association of the solvent abuse with the neuropa
thology, but are unable to assert any causal link.