What is the diagnostic path?

Yes, so interestingly, Alexander disease is not entirely one disorder.

I think a lot of times when we think about getting, for example, cancer at five versus cancer at 15 versus cancer at 50, you know, you think about those things being, um, pretty similar, even if the age is different in terms of, you know, a liver tumor is a liver tumor.

Maybe these are not great examples, and the oncology field won't, field won't agree with me.

But, um, what's unique about Alexander disease is that at different ages or in different phenotypes, the symptoms actually are very different depending on where in the brain, uh, GFAP is accumulated and where there's dysfunction.

So for example, younger children have a lot of what we call supratentorial involvement or the front of the brain, the cerebra- the cerebrum or the frontal lobes are mostly affected, and you will have associated symptoms like developmental delay and seizures and macrocephaly.

Whereas that part of the brain is somewhat spared, not entirely, in some of the older forms of the disease where you have mostly brainstem symptoms.

Are there a cluster of symptoms? Are, are there something that raises a red flag that maybe c- uh, clinicians can, can think Alexander disease and maybe get, uh, look at it closer?