Conclusions
Adult onset leukodystrophies represent a highly complex area of adult neurology, compounded by their rarity, with a total prevalence of 300 cases/million. There is a wealth of information on paediatric leukodystrophies, but adult onset cases can be misdiagnosed as atypical MS or young onset vascular or neurodegenerative dementia. In this overview, our aim is to describe a logical approach to the diagnostic process, reducing unnecessary (and expensive) investigations and using selectively the newer genetic advances.