Subacute necrotizing encephalopathy (Leigh) in an adult.

The case of a 31-year-old man who died after a 4 month illness of adult subacute necrotizing encephalomyelopathy (Leigh) is reported. The disease presented with visual disturbances and the principal symptoms were ptosis, a conjugate ophthalmoparesis and a slight tremor of the hands. The case was misdiagnosed as probable multiple sclerosis. Neuropathology disclosed characteristic symmetrical necrotizing lesions, mainly localized in the brain stem. The similarity of the lesions with Wernicke's disease is pointed out. Possible etiological and pathogenetic factors are discussed.