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MELAS syndrome masquerading as herpes simplex encephalitis

D R Johns1, A G Stein, R Wityk

  • 1Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD.

Neurology
|December 1, 1993
PubMed
Summary
This summary is machine-generated.

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Mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes (MELAS) syndrome can mimic herpes simplex encephalitis (HSE) in adults. This study highlights MELAS syndrome as a mimic of HSE, necessitating broader differential diagnoses for suspected encephalitis.

Area of Science:

  • Neurology
  • Mitochondrial Diseases
  • Infectious Diseases

Background:

  • Herpes simplex encephalitis (HSE) is often treated empirically with acyclovir.
  • Diagnosis typically avoids invasive procedures like brain biopsy.
  • Differential diagnosis for HSE can be challenging.

Observation:

  • Three adult patients presented with symptoms suggestive of HSE.
  • These patients were diagnosed with mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes (MELAS) syndrome.
  • MELAS syndrome presented atypically, mimicking HSE.

Findings:

  • Molecularly verified MELAS syndrome can present with clinical features resembling HSE.
  • Adult MELAS syndrome may manifest as a recurrent, atypical form mimicking HSE.

Related Experiment Videos

  • Acyclovir treatment was initiated empirically for suspected HSE in these cases.

    • Implications:

    • MELAS syndrome should be considered in the differential diagnosis of suspected HSE, especially in recurrent or atypical cases.
    • This expands the list of neurological conditions that can mimic HSE.
    • Rethinking diagnostic approaches for suspected HSE may be necessary to include metabolic disorders.