Table 6.

Seizure Considerations for Patients With Specific Leukodystrophies.

Disease	Special considerations
Alexander disease	Seizures are often an early symptom in infantile Alexander Disease73; the absence of seizures does not exclude other types of Alexander disease
Krabbe disease	Irritability is a common symptom of Krabbe Disease; consider pairing levetiracetam with vitamin B6 (pyridoxine) supplement to alleviate behavioral side effects of levetiracetam77
Vanishing white matter disease	Consider aggressively treating fevers, because both disease progression and seizure activity are known to occur in the setting of fevers
X-linked adrenoleukodystrophy	Ketogenic diet is likely contraindicated due to effect on very long chain fatty acid levels78
Zellweger syndrome (and others associated with polymicrogyria)	Consider proactive seizure treatment
All leukodystrophy patients undergoing hematopoietic stem cell transplant	Consider seizure prophylaxis with levetiracetam79; avoid valproic acid or felbamate due to possible bone marrow suppression