POLG and microcephaly: This study retrospectively compared the Alpers’ syndrome caused by NON-POLG and POLG gene mutations, and found that NON-POLG onset was earlier, mostly in the early infantile period, with prominent infantile spasms, less liver damage, and some microcephaly, most of the survival time after treatment is longer (Table 2; Figure 4), the phenotype is significantly different from the Alpers’ syndrome caused by POLG gene mutation (Sofou et al., 2015), so It may be better for these patients with mutations in NON-POLG to be diagnosed as Alpers-like syndrome.