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Neurology India / May 2015 / Volume 63 / Issue 3 correlating with these imaging findings. A few studies attributed these findings to intra-myelinic edema and microvacuolation as a result of fluid accumulation and separation of the outer layers of the myelin. [5] One study conducted by Simao et al., however, showed that axonal abnormalities might have contributed to the altered signal intensities on MRI rather than changes in myelin. [6] The precise etiology of these changes remains unclear.In conclusion, restricted diffusion in the deep gray nuclei and brainstem is an uncommon but documented finding in infants on VGB and should not be mistaken for a more ominous pathology. The neurologist/pediatrician and radiologist need to be aware of VGB-induced reversible MRI changes, as misdiagnosis as mitochondrial or amino acid metabolism disorders may trigger unwarranted investigations and unnecessary concern for the family.