We have previously reported that cerebral spectra from newborn babies have high phosphomonoester (PME) concentration (7 m mole/kg), low phosphocreatine (PCr) concentration (1 m mole/kg), low PCr/Pi (inorganic phosphate) ratio (2), and intracellular pH 7.1. We present 31-P NMR results in: maple syrup urine disease, congenital lactic acidosis, gluconeogenic disorder, fetal alcohol syndrome, focal seizures and stroke, severe neurogenic arthrogryposis, lobar holoprosencephaly, and Group B strep meningitis. Spectroscopy was performed after recovery from acute metabolic or infectious abnormalities on the hypothesis that there are persistent changes in oxidative metabolites. Thus, during the study, babies were not stressed or given metabolic challenges. As a group, these babies had a phosphate potential (PCr/Pi 1.0) which is characteristic of lactic acidosis. In the child with focal seizures and stroke, PCr/Pi was 0.8 in the injured hemisphere vs 1.8 in the normal hemisphere. In the baby with severe neurogenic arthrogryposis, PCr/Pi in resting muscle was 0.3 vs > 7.0 for normal resting muscle. While there were individual differences, the mean concentration of PCr and PME and mean pH did not differ significantly from control infants. These data suggest that a wide variety of neonatal neurologic syndromes may cause persistent changes in oxidative metabolites and that 31-P NMR spectroscopy may yield significant information on the minimal value of PCr/Pi that is consistent with aerobic metabolism. (NIH T35-HD-07217-1OAI and NIH-HD-15973-01)