Isolated periodic dystonia in the arms and legs was the first manifest
ation in three siblings with Leigh's syndrome. The symptomatology is i
dentical and progressive in both brothers, whereas the progressive, dy
stonic movements of the 14-year old sister have disappeared completely
for the last three years. CSF lactate was increased in both brothers.
All siblings showed MRI abnormalities of the globus pallidus with dif
ferent pronounciation. Since the therapeutic use of alpha-liponic-acid
the recurrent encephalopathic episodes disappeared in both boys witho
ut affecting the dystonic movements. The girl is asymptomatic without
any therapy. Leigh's syndrome is a differential diagnosis in children
with a first manifestation of periodic dystonic movements.