Asymptomatic adult Alexander's disease: entity or nosological misconception?

Two adults were found to have heavy deposits of Rosenthal fibers in the CNS after dying from severe systemic medical illnesses. Previously reported cases of neurologically asymptomatic adult Alexander's disease patients also had complicated systemic disease. We suggest that heavy Rosenthal fiber deposition may occur in the setting of severe medical illness and should not be classified as adult Alexander's disease.