MELAS Missed for Years: Stroke-Like Lesions Are No Indication for Brain Biopsy.
Journal
Case reports in neurological medicine
ISSN: 2090-6668
Titre abrégé: Case Rep Neurol Med
Pays: United States
ID NLM: 101576451
Informations de publication
Date de publication:
2019
2019
Historique:
received:
17
07
2019
accepted:
16
12
2019
entrez:
18
1
2020
pubmed:
18
1
2020
medline:
18
1
2020
Statut:
epublish
Résumé
A 56-year-old female with a history of chronic alcoholism until age 38 y with a relapse between ages 45 and 46 y developed seizures, psychosis, and hemianopia to the left at age 46 y. Imaging revealed a right parieto-occipital lesion with intralesional bleeding. Five months after the first lesion she developed a second left parieto-occipital lesion, resulting in cortical blindness. Extensive workup, including brain biopsy, was noninformative. Retrospectively, the occipital abnormalities were identified as stroke-like lesions (SLLs). Further manifestations of the mitochondrial disorder (MID) were tremor, cerebral atrophy, bilateral basal ganglia, calcification, glaucoma, hypoacusis, short stature, hyperostosis frontalis, hyperthyroidism, sick-sinus syndrome and AV-block-1, and myopathy. According to the Walker criteria, a possible MID was diagnosed. In conclusion, adult-onset MID may be missed for years, SLLs may be easily misinterpreted entailing brain biopsy, and psychosis may contribute to a reduced impact for proper workup of a MID.
Identifiants
pubmed: 31949962
doi: 10.1155/2019/9312451
pmc: PMC6948273
doi:
Types de publication
Case Reports
Langues
eng
Pagination
9312451Informations de copyright
Copyright © 2019 J. Finsterer.
Déclaration de conflit d'intérêts
The author declares that there are no conflicts of interest.
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