title: Transient ischemic attack-like episodes without stroke-like lesions in MELAS.
abstract: A stroke-like episode is a core symptom in mitochondrial myopathy, encephalopathy, lactic acidosis and stroke-like episodes (MELAS). Proton magnetic resonance spectroscopy (1H-MRS) is useful in the diagnosis of mitochondrial diseases. We report an 8-year-old girl with MELAS, presenting with a seizure and blindness. 1H-MRS showed a strikingly elevated lactate peak in the right occipital region, where no abnormal signals appeared on either T2-W or diffusion-weighted MRI. She recovered completely within a day. We describe this mild clinical condition with abnormal lactate peak in normal-appearing gray matter as a transient ischemic attack-like episode in MELAS.
authors.affiliation: Division of Neurology, Kanagawa Children's Medical Center, Mutsukawa 2-138-4, Minami-ku, Yokohama, Kanagawa, 232-8555, Japan.
authors.forename: Tadahiro
authors.initials: T
authors.lastname: Mitani
authors.forename: Noriko
authors.initials: N
authors.lastname: Aida
authors.forename: Moyoko
authors.initials: M
authors.lastname: Tomiyasu
authors.forename: Takahito
authors.initials: T
authors.lastname: Wada
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Osaka
mesh_terms: D015415:Biomarkers / Q000032:analysis; D001921:Brain / Q000378:metabolism* / Q000473:pathology*; D002648:Child; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D002546:Ischemic Attack, Transient / Q000175:diagnosis* / Q000378:metabolism*; D019344:Lactic Acid / Q000032:analysis*; D017241:MELAS Syndrome / Q000175:diagnosis* / Q000378:metabolism*; D008279:Magnetic Resonance Imaging / Q000379:methods; D009682:Magnetic Resonance Spectroscopy / Q000379:methods; D011522:Protons; D020521:Stroke / Q000175:diagnosis / Q000378:metabolism
chemical_list: D015415:Biomarkers; D011522:Protons; D019344:Lactic Acid