Childhood cerebral ALD is the most devastating form of ALD, representing about 35% of all cases. It is characterized by an inflammatory process that destroys the myelin, causing relentless progressive deterioration. It generally occurs between the ages of four and ten years old. Normal, healthy boys suddenly begin to regress. Which boy will get cerebral ALD is unknown and is different amongst family members (i.e. one brother may get cerebral ALD and one may not).
Cerebral ALD can also occur in men. At least 20 percent of all affected men develop cognitive decline similar and cerebral ALD to that seen in boys with childhood cerebral forms. These patients develop progressive neurological symptoms similar to childhood cerebral ALD and typically result in severe neurological impairment, and eventually vegetative state or death.