title: White matter involvement in mitochondrial diseases.
abstract: White matter involvement is recently being realized as a common finding in mitochondrial disorders. It is considered an inherent part of the classical mitochondrial syndromes which are usually associated with alterations in the mitochondrial DNA such as: Leigh disease, Kearns-Sayre syndrome, mitochondrial encephalomyopathy lactic acidosis, and stroke like episodes, mitochondrial neuro-gastro-intestinal encephalomyopathy and Leber's hereditary optic neuropathy. White matter involvement is also described in mitochondrial disorders due to mutations in the nuclear DNA which are transmitted in an autosomal pattern. MRI findings suggestive of a mitochondrial disease are: small cyst-like lesions in abnormal white matter, involvement of both cerebral and cerebellar white matter, and a combination of a leukoencephalopathy with bilateral basal ganglia lesions. The clinical manifestations may be disproportionate to the extent of white matter involvement. Other organs may frequently be involved. The onset is often in infancy with a neurodegenerative course. The finding of a leukoencephalopathy in a patient with a complex neurologic picture and multisystem involvement should prompt a thorough mitochondrial evaluation.
authors.affiliation: The Mitochondrial Disease Clinic, Metabolic-Neurogenetic Service, Wolfson Medical Center, Pediatric Neurology Unit, Holon, Israel. asagie@post.tau.ac.il
authors.forename: Tally
authors.initials: T
authors.lastname: Lerman-Sagie
authors.forename: Esther
authors.initials: E
authors.lastname: Leshinsky-Silver
authors.forename: Nathan
authors.initials: N
authors.lastname: Watemberg
authors.forename: Yehudit
authors.initials: Y
authors.lastname: Luckman
authors.forename: Dorit
authors.initials: D
authors.lastname: Lev
mesh_terms: D001927:Brain Diseases / Q000473:pathology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D028361:Mitochondrial Diseases / Q000473:pathology*