Authors :
Fawad Khan, MD – Ochsner Health
Presenting Author: Masoud Yeganegi, MD, MASc – Ochsner Health
Joseph Tarsia, MD – Ochsner Health
Andrew Steven, MD – Ochsner Health
Rationale:
Mitochondrial Encephalopathy, Lactic Acidosis, and Stroke-like episodes (MELAS) is a mitochondrial disorder characterized by a broad spectrum of neurological manifestations, including stroke-like episodes, headaches, and seizures. This disorder is caused by mutations in mitochondrial DNA, leading to disrupted oxidative phosphorylation and neuronal injury.
Methods:
We describe the clinical course of a 28-year-old male with MELAS who presented to Ochsner Hospitals with new stroke-like episodes from January 2024 to September 2024. We reviewed the clinical presentation, EEG abnormalities, and MRI cortical abnormalities during each hospitalization. Additionally, we reviewed the medical literature for EEG abnormalities reported in patients with MELAS.
Results:
The patient was admitted 8 times for new neurological symptoms during this period. MRI brain imaging revealed new signal abnormalities in cortical and subcortical regions that corresponded with clinical symptoms. We further analyzed dynamic EEG data corresponding to the imaging abnormalities and assessed the response to treatments for seizures and epileptiform abnormalities. The EEG abnormalities reported in previous cases in the medical literature were also categorized.
Conclusions: We observed a strong correlation between EEG abnormalities and neuroimaging changes in MELAS. Serial EEGs offer critical insights into the brain's functional status and are instrumental in evaluating the evolving pathological changes during acute episodes of the disease. Our observations are supported by other reports of serial EEG findings. Further neurophysiological studies on MELAS patients are needed to identify early signs of disease progression.
Funding: n/a