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 Indian J Med Microbiol  
 

Figure 13 (A-D): Leigh disease with SURF-1 mutation – A 1-year- old girl presented with regression of milestones along with feeding difficulties, following a febrile episode 4 months ago. (A) Axial T2WI reveals bilateral symmetrical hyperintense signal in the caudate, putamen (black arrows). (B and C) Coronal T2WI shows bilateral symmetrical hyperintense signal in substantia nigra (black arrows), subthalamic nuclei, and dentate nuclei (black arrowheads). Patchy areas of diffusion restriction and postcontrast enhancement were noted in these regions (not shown). (D) MRS at TE 135 ms shows inverted lactate peaks at 1.33 ppm (white arrows)

Figure 13 (A-D): Leigh disease with <i>SURF-1</i> mutation – A 1-year- old girl presented with regression of milestones along with feeding difficulties, following a febrile episode 4 months ago. (A) Axial T2WI reveals bilateral symmetrical hyperintense signal in the caudate, putamen <i>(black arrows)</i>. (B and C) Coronal T2WI shows bilateral symmetrical hyperintense signal in substantia nigra <i>(black arrows)</i>, subthalamic nuclei, and dentate nuclei <i>(black arrowheads)</i>. Patchy areas of diffusion restriction and postcontrast enhancement were noted in these regions (not shown). (D) MRS at TE 135 ms shows inverted lactate peaks at 1.33 ppm <i>(white arrows)</i>