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### Learning Point for CliniciansChildhood-onset mitochondrial encephalomyopathies usually present with a progressive course with a fatal outcome. These assumed irreversible conditions prompt clinicians and parents to face end-of-life decisions for a young child. However, this unfortunate situation can be overcome via a molecular diagnosis that can grant a favorable prognosis with continuing intensive supportive care.### Patient 1A 6-week-old boy was admitted to the pediatric intensive care unit (PICU) for frequent choking and apnea, requiring gavage feeding and assisted ventilation. He developed generalized weakness and sucking difficulties soon after birth. He exhibited profound hypotonia and hyporeflexia. The serum lactate was 9.6 mmol/l (normal reference: 0.5–2.2) and the creatine kinase (CK) 700 U/l (normal reference: 200). Muscle biopsy from the biceps brachii suggested a …

Benign reversible course in infants manifesting clinicopathological features of fatal mitochondrial myopathy due to m.14674 T>C mt-tRNAGlu mutation