Proton spectroscopy in five patients with Leigh's disease and mitochondrial enzyme deficiency.

Five children with Leigh's disease and progressive neurological symptoms were compared with 14 control children. In all patients, MRI showed bilateral lesions of the putamina and caudate heads. Serum lactate was normal for four of the children, and CSF lactate slightly elevated for three. Volume-selective proton MR spectroscopy (1H-MRS) of the basal ganglia in the Leigh patients revealed elevated lactate, giving further evidence for a defect of energy metabolism in the brain. 1H-MRS is an important tool for non-invasive brain tissue analysis in Leigh's disease, particularly in the absence of peripheral lactate elevation.