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Leigh syndrome in a 10-year-old male with progressive right upper extremity weakness and left leg pain. (a) Axial T2WI shows T2 hyperintense necrotic lesions in the lentiform nuclei (arrows). (b) SV-MRS (short TE) over the basal ganglia shows increased Lac at 1.3 ppm consistent with anaerobic metabolism (indicating active on chronic disease, given the MRI appearance) and reduced NAA.
