Evidence for cardioembolic stroke in a case of Kearns-Sayre syndrome.
BACKGROUND
Cerebral infarction is a known complication in patients with mitochondrial encephalomyopathies (MELAS, MERRF, Kearns-Sayre syndrome), but the etiology in the different types remains uncertain.


METHODS
A 33-year-old woman who had suffered from ophthalmoplegia, bilateral ptosis, ataxia, retinitis pigmentosa, and epilepsy since childhood was diagnosed to have Kearns-Sayre syndrome. The diagnosis was confirmed by muscle biopsy when she was 17 years old. A pacemaker was implanted because of the occurrence of bradyarrhythmias when she was 24 years old. The patient was admitted to the hospital with left-sided hemiparesis of sudden onset due to right striatocapsular infarction. Results of Doppler sonography of the carotid arteries were normal; however, transesophageal echocardiography revealed a thrombus in the left atrial appendage.


CONCLUSIONS
Stroke in Kearns-Sayre syndrome is likely to be due to cardiac embolism. Anticoagulant therapy should be considered even for mild forms of cardiomyopathies leading to left ventricular dysfunction.
Kosinski
C
C
Department of Neurology, Technical University of Aachen, Germany.
Mull
M
M
Lethen
H
H
Töpper
R
R
D000293:Adolescent; D000328:Adult; D002544:Cerebral Infarction / Q000000981:diagnostic imaging / Q000209:etiology; D017548:Echocardiography, Transesophageal; D005260:Female; D006331:Heart Diseases / Q000150:complications* / Q000000981:diagnostic imaging; D006429:Hemiplegia / Q000209:etiology; D006801:Humans; D002542:Intracranial Embolism and Thrombosis / Q000000981:diagnostic imaging / Q000209:etiology*; D007625:Kearns-Sayre Syndrome / Q000150:complications*; D013927:Thrombosis / Q000150:complications* / Q000000981:diagnostic imaging; D018608:Ultrasonography, Doppler