Late-Onset Mitochondrial Myopathy, Encephalopathy, Lactic Acidosis, and Strokelike Episodes With Bitemporal Lesions

Diagnosis of adult-onset MELAS syndrome in a 63-year-old patient with suspected recurrent strokes – a case report

“…In our patient, stroke-like episodes first occurred at 63 years of age, which is highly unusual for MELAS. Indeed, we only found reports on 21 patients with an adult onset (age > 50 years) in the literature, of whom only 8 were older than 60 years at first onset of symptoms [5–11]. Indeed, our patient was misdiagnosed as having recurrent strokes of arterio-arterial embolic origin.…”

Diagnosis of adult-onset MELAS syndrome in a 63-year-old patient with suspected recurrent strokes – a case report

“…In our patient, stroke-like episodes first occurred at 63 years of age, which is highly unusual for MELAS. Indeed, we only found reports on 21 patients with an adult onset (age > 50 years) in the literature, of whom only 8 were older than 60 years at first onset of symptoms [5–11]. Indeed, our patient was misdiagnosed as having recurrent strokes of arterio-arterial embolic origin.…”

Importance of Distinguishing Between Mitochondrial Encephalomyopathy With Elderly Onset of Stroke-Like Episodes and Cerebral Infarction

“…Specifically, in cases of elderly onset stroke-like episodes such as our case, it is possible that the patients’ brains carry an even lower mitochondrial mutation load. Although there are some published cases of adult-onset patients who presented with MELAS with the m.3243A>G mutation [ 10 , 13 - 15 ], elderly MELAS patients over the age of 65 are not commonly reported [ 5 , 6 ] ( Table 1 ). To the best of our knowledge, the present case is only the third such report.…”

Mitochondrial encephalomyopathy with lactic acidosis and stroke-like episodes (MELAS) in the older adult

“…It is uncertain why neurological dysfunction is delayed in some patients with MELAS, but it may be that these patients’ brains have a lower mitochondrial mutation load 14. The pathophysiology of stroke-like episodes, a hallmark of this disorder, is unknown but may represent ‘metabolic strokes’ due to deficiency of adenosine triphosphatase, limited oxidative glucose metabolism, increased lactic acid production or mitochondrial angiopathy.…”

Diagnosis of adult-onset MELAS syndrome in a 63-year-old patient with suspected recurrent strokes – a case report

“…In our patient, stroke-like episodes first occurred at 63 years of age, which is highly unusual for MELAS. Indeed, we only found reports on 21 patients with an adult onset (age > 50 years) in the literature, of whom only 8 were older than 60 years at first onset of symptoms [5–11]. Indeed, our patient was misdiagnosed as having recurrent strokes of arterio-arterial embolic origin.…”

Importance of Distinguishing Between Mitochondrial Encephalomyopathy With Elderly Onset of Stroke-Like Episodes and Cerebral Infarction

“…Specifically, in cases of elderly onset stroke-like episodes such as our case, it is possible that the patients’ brains carry an even lower mitochondrial mutation load. Although there are some published cases of adult-onset patients who presented with MELAS with the m.3243A>G mutation [ 10 , 13 - 15 ], elderly MELAS patients over the age of 65 are not commonly reported [ 5 , 6 ] ( Table 1 ). To the best of our knowledge, the present case is only the third such report.…”

Mitochondrial encephalomyopathy with lactic acidosis and stroke-like episodes (MELAS) in the older adult

“…It is uncertain why neurological dysfunction is delayed in some patients with MELAS, but it may be that these patients’ brains have a lower mitochondrial mutation load 14. The pathophysiology of stroke-like episodes, a hallmark of this disorder, is unknown but may represent ‘metabolic strokes’ due to deficiency of adenosine triphosphatase, limited oxidative glucose metabolism, increased lactic acid production or mitochondrial angiopathy.…”

Diagnosis of adult-onset MELAS syndrome in a 63-year-old patient with suspected recurrent strokes – a case report

“…In our patient, stroke-like episodes first occurred at 63 years of age, which is highly unusual for MELAS. Indeed, we only found reports on 21 patients with an adult onset (age > 50 years) in the literature, of whom only 8 were older than 60 years at first onset of symptoms [5–11]. Indeed, our patient was misdiagnosed as having recurrent strokes of arterio-arterial embolic origin.…”

Importance of Distinguishing Between Mitochondrial Encephalomyopathy With Elderly Onset of Stroke-Like Episodes and Cerebral Infarction

“…Specifically, in cases of elderly onset stroke-like episodes such as our case, it is possible that the patients’ brains carry an even lower mitochondrial mutation load. Although there are some published cases of adult-onset patients who presented with MELAS with the m.3243A>G mutation [ 10 , 13 - 15 ], elderly MELAS patients over the age of 65 are not commonly reported [ 5 , 6 ] ( Table 1 ). To the best of our knowledge, the present case is only the third such report.…”

Mitochondrial encephalomyopathy with lactic acidosis and stroke-like episodes (MELAS) in the older adult

“…It is uncertain why neurological dysfunction is delayed in some patients with MELAS, but it may be that these patients’ brains have a lower mitochondrial mutation load 14. The pathophysiology of stroke-like episodes, a hallmark of this disorder, is unknown but may represent ‘metabolic strokes’ due to deficiency of adenosine triphosphatase, limited oxidative glucose metabolism, increased lactic acid production or mitochondrial angiopathy.…”