We describe the unfavourable neurological outcome of a galactosemic patient who however received an appropriate diet from the neonatal period. The magnetic resonance imaging showed significantly abnormal myelinization of the brain. The biochemical hypotheses at the origin of this abnormal cerebral myelinization are discussed in our patient. The 1-14C incorporation in the TCA precipitable glycoproteins reached 21% of the average value observed in 6 controls; it ranged from 37% to 59% for galactosemic patients without neurological disturbances. These results, which have to be confirmed, suggest that some galactosemic patients have a very low UDP-galactose synthesis.