Childhood leukodystrophy presenting as secondary bipolar disorder.

Leukodystrophies are rare dysmyelinating disorders of the nervous system, which occasionally have an initial psychiatric presentation. This report describes a case of a 9-year-old boy whose initial presentation resembled a bipolar disorder but subsequent work-up revealed an underlying leukodystrophy, most likely Alexander's disease. The course of this rare disease along with the implications of making a diagnosis of leukodystrophy in a psychiatric setting is discussed.