Magnetic resonance imaging differential diagnosis of brainstem lesions in children

Figure 6 Leigh’s syndrome in complex IV deficiency. A 3-year-old male (heterozygous mutation of the SURF1 gene, responsible for assembly of the complex IV) with convergent strabism and ataxia. Axial (A-D, F) and coronal (E) T2 weighted images show hyperintense lesions at the brainstem. Bilateral and symmetric lesions involve inferior olivary nuclei (white arrows in A), bilateral medial longitudinal fasciculus (black arrows in B) and medial lemniscus (white arrows in B) in the caudal pons (B), and the medial longitudinal fasciculus in the cranial pons (black arrows in C) and midbrain (black arrows in D).