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SPIN | Society of Pediatric Neuroimaging Profile picture
SPIN | Society of Pediatric Neuroimaging
@spinacademics
The Society of Pediatric Neuroimaging | A dynamic faculty from the world’s leading children’s hospitals leading the way in education and research
Nov 5, 2025 • 14 tweets • 3 min read
🧵 SPIN TWEETORIAL WEDNESDAY

LBSL — The tract-selective mitochondrial leukodystrophy
(DARS2-related)

There are leukodystrophies that blur the brain.
And then there are leukodystrophies that trace pathways with intention.
LBSL belongs to the latter.

Back to basics! Image 1/ Clinically, think slowly progressive:

Ataxia

Spastic paraparesis

Loss of vibration/position sense

Legs more affected than arms.
Reflexes are often preserved — and that alone is a beautiful clue.
Speech may become slurred with time.

Seizures can occur but are usually mild