Fig. 2

Brain and spinal cord T2-weighted MRI representative of LBSL. a–d, f Axial and e sagittal images show inhomogeneous signal abnormalities in the cerebral white matter (a), corticospinal tracts (b), superior cerebellar peduncles, medial lemniscus (c), pyramids, inferior cerebellar peduncles, cerebellar white matter (d), lateral corticospinal tracts, dorsal columns (e, f), and elevated lactate in magnetic resonance spectroscopy (g), thus meeting all major and some minor MRI criteria for LBSL (leukoencephalopathy with brainstem and spinal cord involvement and lactate elevation). Reprinted with permission [31].