Extraordinary reviews or case reports have well described the imaging patterns of brain involvement, while there are few published case reports specifically focused on spinal cord involvement in LS patients, especially those with definite genetic mutations [[3]-[6]]. Extended spinal cord involvement in adult-onset Leigh syndrome due to mitochondrial 10197G > A mutation Dear Editor, Leigh syndrome (LS) is a progressive neurodegenerative disorder with characteristic symmetric lesions of the bilateral basal ganglia, thalami, and brainstem [[1]]. Here, we report a mother and her son both diagnosed with adult-onset LS due to m. 10197G > A mutation, while the son presented with outstanding spinal cord lesions. [Extracted from the article]