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MELAS presenting as migraine complicated by stroke: case report
K Ohno1, E Isotani, K Hirakawa
1Department of Neurosurgery, Tokyo Medical and Dental University, Japan.
Neuroradiology
|December 24, 1997
Summary
Mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes (MELAS) can mimic migraine with stroke. Early consideration of MELAS is crucial for young adults with stroke-like lesions and migrainous headaches.
Area of Science:
- Neurology
- Genetics
- Mitochondrial Diseases
Background:
- Strokes associated with migraine are frequently reported, but underlying mechanisms are not fully understood.
- Migraineurs may experience various pathologies contributing to stroke.
- Mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes (MELAS) is a specific condition presenting with migrainous headache.
Observation:
- This case report details a patient whose presentation mimicked migraine complicated by stroke.
- The patient experienced migrainous headache, vomiting, and stroke-like symptoms consistent with MELAS.
- Magnetic resonance imaging revealed characteristic findings indicative of MELAS.
Findings:
- MELAS should be included in the differential diagnosis for young adults presenting with infarct-like lesions and migrainous headaches.
- Fluctuating symptoms and homonymous hemianopia are key indicators for considering MELAS.
- Characteristic MRI findings aid in diagnosing MELAS.
Implications:
- Recognizing MELAS in patients with migraine-like symptoms and stroke is critical for timely diagnosis and management.
- This case highlights the importance of considering rare mitochondrial disorders in neurological presentations.
- Further research into the link between MELAS and cerebrovascular events may elucidate underlying mechanisms.