Leigh Syndrome: Serial CT and MR imaging findings

Serial CT and MRI findings in five patients (two boys and three girls) with Leigh syndrome were retrospectively reviewed in a follow-up period lasting from six months to 10 years. The two boys were found to have cytochrome c oxidase deficiency and one of the girls to have mitochondrial DNA mutation, while the remaining two girls had no detectable enzyme deficiency. CT and MRI revealed symmetrical involvement of the brain bilaterally in all cases. The focal lesions were found most frequently in putamina and caudate nuclei (four cases each), followed by thalami (three cases), globi pallidi, and midbrain (two cases each). In addition, diffuse white matter and/or cortical lesions were disclosed in three cases. MRI and CT at an early stage of the disease revealed swollen, symmetrical lesions which showed shrinkage in size accompanied by the adjacent brain atrophy on later images. Some lesions were detected only in the early stage and were not shown in later images. Thus, careful reading of sequential changes appears to be required for accurate diagnosis of Leigh syndrome.