In Leigh syndrome, individuals can experience a neuro metabolic crisis within the first few months of life, triggered by stressors like infection or dehydration, leading to brainstem, basal ganglia, or spinal cord lesions.

“most of these kids are actually born developmentally Wow and then within the first couple of months of life there's some sort of a stressor sometimes it's some sort of an infection sometimes it's a dehydration that'll put them into a neuro metabolic crisis and at that point if you look at their brain of our eyes you'll see lesions in the brainstem the basal ganglia sometimes the spinal cord corresponding to regions of necrosis”