Document Detail


Regression of stroke-like lesions in MELAS-syndrome after seizure control.
MedLine Citation:
PMID:  21059492     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
There are some indications that seizure activity promotes the development of stroke-like episodes, or vice versa, in patients with mitochondrial encephalopathy, lactic acidosis and stroke-like episodes (MELAS) syndrome or other syndromic mitochondrial disorders. A 41-year-old Caucasian female with MELAS syndrome, presenting with short stature, microcytic anaemia, increased blood-sedimentation rate, myopathy, hyper-gammaglobulinaemia, an iron-metabolism defect, migraine-like headaches, and stroke-like episodes, developed complex partial and generalised seizures at age 32 years. Valproic acid was ineffective but after switching to lamotrigine and lorazepam, she became seizure-free for five years and stroke-like episodes did not recur. Cerebral MRI initially showed enhanced gyral thickening and a non-enhanced T2-hyperintensity over the left parieto-temporo-occipital white matter and cortex and enhanced caudate heads. After two years without seizures, the non-enhanced hyperintense parieto-temporo-occipital lesion had disappeared, being attributed to consequent seizure control. The caudate heads, however, remained hyperintense throughout the observational period. This case indicates that adequate seizure control in a patient with MELAS syndrome may prevent the recurrence of stroke-like episodes and may result in the disappearance of stroke-like lesions on MRI.
Authors:
Josef Finsterer; Peter Barton
Publication Detail:
Type:  Case Reports; Journal Article     Date:  2010-11-09
Journal Detail:
Title:  Epileptic disorders : international epilepsy journal with videotape     Volume:  12     ISSN:  1294-9361     ISO Abbreviation:  Epileptic Disord     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-12-24     Completed Date:  2011-03-08     Revised Date:  2013-08-21    
Medline Journal Info:
Nlm Unique ID:  100891853     Medline TA:  Epileptic Disord     Country:  France    
Other Details:
Languages:  eng     Pagination:  330-4     Citation Subset:  IM    
Affiliation:
Krankenanstalt Rudolfstiftung, Institute of Radiology Urania, Vienna, Austria. fifigs1@yahoo.de
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MeSH Terms
Descriptor/Qualifier:
Adult
Anticonvulsants / therapeutic use
Cerebral Cortex / pathology*
Diagnosis, Differential
Electroencephalography
Female
Humans
Lorazepam / therapeutic use
MELAS Syndrome / complications,  diagnosis*,  drug therapy*,  pathology,  physiopathology
Magnetic Resonance Imaging*
Remission Induction
Seizures / diagnosis*,  drug therapy*,  etiology,  pathology,  physiopathology
Treatment Outcome
Triazines / therapeutic use
Chemical
Reg. No./Substance:
0/Anticonvulsants; 0/Triazines; 846-49-1/Lorazepam; U3H27498KS/lamotrigine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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