MELAS Missed for Years: Stroke-Like Lesions Are No Indication for Brain Biopsy
A 56-year-old female with a history of chronic alcoholism until age 38 y with a relapse between ages 45 and 46 y developed seizures, psychosis, and hemianopia to the left at age 46 y. Imaging revealed a right parieto-occipital lesion with intralesional bleeding. Five months after the first lesion sh...
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Wiley
2019-01-01
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| Series: | Case Reports in Neurological Medicine |
| Online Access: | http://dx.doi.org/10.1155/2019/9312451 |
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| author | J. Finsterer |
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| author_sort | J. Finsterer |
| collection | DOAJ |
| description | A 56-year-old female with a history of chronic alcoholism until age 38 y with a relapse between ages 45 and 46 y developed seizures, psychosis, and hemianopia to the left at age 46 y. Imaging revealed a right parieto-occipital lesion with intralesional bleeding. Five months after the first lesion she developed a second left parieto-occipital lesion, resulting in cortical blindness. Extensive workup, including brain biopsy, was noninformative. Retrospectively, the occipital abnormalities were identified as stroke-like lesions (SLLs). Further manifestations of the mitochondrial disorder (MID) were tremor, cerebral atrophy, bilateral basal ganglia, calcification, glaucoma, hypoacusis, short stature, hyperostosis frontalis, hyperthyroidism, sick-sinus syndrome and AV-block-1, and myopathy. According to the Walker criteria, a possible MID was diagnosed. In conclusion, adult-onset MID may be missed for years, SLLs may be easily misinterpreted entailing brain biopsy, and psychosis may contribute to a reduced impact for proper workup of a MID. |
| format | Article |
| id | doaj-art-129f41dcaa0b4f7387f11ec31fd2aa46 |
| institution | Kabale University |
| issn | 2090-6668 2090-6676 |
| language | English |
| publishDate | 2019-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Neurological Medicine |
| spelling | doaj-art-129f41dcaa0b4f7387f11ec31fd2aa462025-02-03T06:12:34ZengWileyCase Reports in Neurological Medicine2090-66682090-66762019-01-01201910.1155/2019/93124519312451MELAS Missed for Years: Stroke-Like Lesions Are No Indication for Brain BiopsyJ. Finsterer0Krankenanstalt Rudolfstiftung, Messerli Institute, Vienna, AustriaA 56-year-old female with a history of chronic alcoholism until age 38 y with a relapse between ages 45 and 46 y developed seizures, psychosis, and hemianopia to the left at age 46 y. Imaging revealed a right parieto-occipital lesion with intralesional bleeding. Five months after the first lesion she developed a second left parieto-occipital lesion, resulting in cortical blindness. Extensive workup, including brain biopsy, was noninformative. Retrospectively, the occipital abnormalities were identified as stroke-like lesions (SLLs). Further manifestations of the mitochondrial disorder (MID) were tremor, cerebral atrophy, bilateral basal ganglia, calcification, glaucoma, hypoacusis, short stature, hyperostosis frontalis, hyperthyroidism, sick-sinus syndrome and AV-block-1, and myopathy. According to the Walker criteria, a possible MID was diagnosed. In conclusion, adult-onset MID may be missed for years, SLLs may be easily misinterpreted entailing brain biopsy, and psychosis may contribute to a reduced impact for proper workup of a MID.http://dx.doi.org/10.1155/2019/9312451 |
| spellingShingle | J. Finsterer MELAS Missed for Years: Stroke-Like Lesions Are No Indication for Brain Biopsy Case Reports in Neurological Medicine |
| title | MELAS Missed for Years: Stroke-Like Lesions Are No Indication for Brain Biopsy |
| title_full | MELAS Missed for Years: Stroke-Like Lesions Are No Indication for Brain Biopsy |
| title_fullStr | MELAS Missed for Years: Stroke-Like Lesions Are No Indication for Brain Biopsy |
| title_full_unstemmed | MELAS Missed for Years: Stroke-Like Lesions Are No Indication for Brain Biopsy |
| title_short | MELAS Missed for Years: Stroke-Like Lesions Are No Indication for Brain Biopsy |
| title_sort | melas missed for years stroke like lesions are no indication for brain biopsy |
| url | http://dx.doi.org/10.1155/2019/9312451 |
| work_keys_str_mv | AT jfinsterer melasmissedforyearsstrokelikelesionsarenoindicationforbrainbiopsy |