Skip to main content
Advertisement
  • Neurology.org
  • Journals
    • Neurology
    • Clinical Practice
    • Genetics
    • Neuroimmunology & Neuroinflammation
  • Specialty Sites
    • COVID-19
    • Practice Current
    • Practice Buzz
    • Without Borders
    • Equity, Diversity and Inclusion
    • Innovations in Care Delivery
  • Collections
    • Topics A-Z
    • Residents & Fellows
    • Infographics
    • Patient Pages
    • Null Hypothesis
    • Translations
  • Podcast
  • CME
  • About
    • About the Journals
    • Contact Us
    • Editorial Board
  • Authors
    • Submit a Manuscript
    • Author Center

Advanced Search

Main menu

  • Neurology.org
  • Journals
    • Neurology
    • Clinical Practice
    • Genetics
    • Neuroimmunology & Neuroinflammation
  • Specialty Sites
    • COVID-19
    • Practice Current
    • Practice Buzz
    • Without Borders
    • Equity, Diversity and Inclusion
    • Innovations in Care Delivery
  • Collections
    • Topics A-Z
    • Residents & Fellows
    • Infographics
    • Patient Pages
    • Null Hypothesis
    • Translations
  • Podcast
  • CME
  • About
    • About the Journals
    • Contact Us
    • Editorial Board
  • Authors
    • Submit a Manuscript
    • Author Center
  • Home
  • Latest Articles
  • Current Issue
  • Past Issues
  • Residents & Fellows

User menu

  • Subscribe
  • My Alerts
  • Log in

Search

  • Advanced search
Neurology
Home
The most widely read and highly cited peer-reviewed neurology journal
  • Subscribe
  • My Alerts
  • Log in
Site Logo
  • Home
  • Latest Articles
  • Current Issue
  • Past Issues
  • Residents & Fellows

Share

April 18, 2017; 88 (16 Supplement) April 23, 2017

MELAS Syndrome: How Stroke-like are the Stroke episodes? (P1.255)

Nicholas Liaw, Richard Lewis, Vasu Saini, Sakir Humayun Gultekin, Sebastian Koch, Negar Asdaghi
First published April 17, 2017,
Nicholas Liaw
1Neurology Miami FL United States
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Richard Lewis
1Neurology Miami FL United States
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Vasu Saini
1Neurology Miami FL United States
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Sakir Humayun Gultekin
2Pathology, University of Miami Miller School of Medicine Miami FL United States
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Sebastian Koch
1Neurology Miami FL United States
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Negar Asdaghi
1Neurology Miami FL United States
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Citation
MELAS Syndrome: How Stroke-like are the Stroke episodes? (P1.255)
Nicholas Liaw, Richard Lewis, Vasu Saini, Sakir Humayun Gultekin, Sebastian Koch, Negar Asdaghi
Neurology Apr 2017, 88 (16 Supplement) P1.255;

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Permissions

Make Comment

See Comments

Downloads
0

Share

  • Article
  • Info & Disclosures
Loading

Abstract

Objective: To discuss the acute neuroimaging findings of stroke like episodes (SLEs) in patients with MELAS syndrome (Mitochondrial myopathy, Encephalopathy, Lactic acidosis, and Stroke-like episodes).

Background: The pathophysiology, neuroimaging and treatment of SLEs are thought to be different from that of arterial ischemic stroke in patients with MELAS syndrome. An overlap in acute neuroimaging characteristics have been reported between SLEs and arterial ischemic stroke in terms of diffusion weighted Imaging (DWI) sequences, but the SLEs do not conform to a vascular territory. Here we report a case of MELAS with recurrent arterial strokes.

Design/Methods: Case report study and review of the neuroimaging literature in MELAS.

Results: A 50 year-old right-handed Hispanic man with a history of primary hypoparathyroidism, diabetes mellitus, chronic kidney disease, sensorineural deafness, and short stature presented with global aphasia and unresponsiveness. He had a positive DWI lesion (high DWI/low ADC signal) in the inferior division of the left middle cerebral artery (MCA) in keeping with an acute ischemic stroke. Apart from lactic acidosis, extensive stroke workup was inconclusive for a stroke etiology. He was treated with Aspirin. He presented one month later with recurrent lactic acidosis, right gaze deviation and altered mental status. Repeat MRI showed a new DWI positive lesion in the same vascular territory as the first event. Muscle biopsy revealed ragged red fibers and histology consistent with mitochondrial dysfunction. The diagnosis of MELAS syndrome was made and the patient was treated coenzyme Q10.

Conclusions: Patients with MELAS syndrome may present with recurrent strokes in the arterial territory rather than SLEs. Clinicians should entertain the possibility of a mitochondrial disease in young patients with cryptogenic stroke and pursue appropriate diagnostic evaluations and treatment.

Disclosure: Dr. Liaw has nothing to disclose. Dr. Lewis has nothing to disclose. Dr. Saini has nothing to disclose. Dr. Gultekin has nothing to disclose. Dr. Koch has nothing to disclose. Dr. Asdaghi has nothing to disclose.

Disputes & Debates: Rapid online correspondence

No comments have been published for this article.
Comment

NOTE: All authors' disclosures must be entered and current in our database before comments can be posted. Enter and update disclosures at http://submit.neurology.org. Exception: replies to comments concerning an article you originally authored do not require updated disclosures.

  • Stay timely. Submit only on articles published within the last 8 weeks.
  • Do not be redundant. Read any comments already posted on the article prior to submission.
  • 200 words maximum.
  • 5 references maximum. Reference 1 must be the article on which you are commenting.
  • 5 authors maximum. Exception: replies can include all original authors of the article.
  • Submitted comments are subject to editing and editor review prior to posting.

More guidelines and information on Disputes & Debates

Compose Comment

More information about text formats

Plain text

  • No HTML tags allowed.
  • Web page addresses and e-mail addresses turn into links automatically.
  • Lines and paragraphs break automatically.
Author Information
NOTE: The first author must also be the corresponding author of the comment.
First or given name, e.g. 'Peter'.
Your last, or family, name, e.g. 'MacMoody'.
Your email address, e.g. higgs-boson@gmail.com
Your role and/or occupation, e.g. 'Orthopedic Surgeon'.
Your organization or institution (if applicable), e.g. 'Royal Free Hospital'.
Publishing Agreement
NOTE: All authors, besides the first/corresponding author, must complete a separate Disputes & Debates Submission Form and provide via email to the editorial office before comments can be posted.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.

Vertical Tabs

You May Also be Interested in

Back to top
  • Article
  • Info & Disclosures
Advertisement

Related Articles

  • No related articles found.

Alert Me

  • Alert me when eletters are published
Neurology: 96 (8)

Articles

  • Ahead of Print
  • Current Issue
  • Past Issues
  • Popular Articles
  • Translations

About

  • About the Journals
  • Ethics Policies
  • Editors & Editorial Board
  • Contact Us
  • Advertise

Submit

  • Author Center
  • Submit a Manuscript
  • Information for Reviewers
  • AAN Guidelines
  • Permissions

Subscribers

  • Subscribe
  • Activate a Subscription
  • Sign up for eAlerts
  • RSS Feed
Site Logo
  • Visit neurology Template on Facebook
  • Follow neurology Template on Twitter
  • Visit Neurology on YouTube
  • Neurology
  • Neurology: Clinical Practice
  • Neurology: Genetics
  • Neurology: Neuroimmunology & Neuroinflammation
  • AAN.com
  • AANnews
  • Continuum
  • Brain & Life
  • Neurology Today

Wolters Kluwer Logo

Neurology | Print ISSN:0028-3878
Online ISSN:1526-632X

© 2021 American Academy of Neurology

  • Privacy Policy
  • Feedback
  • Advertise