Mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episodes (MELAS) is a mitochondrial disorder characterized by fluctuating encephalopathy, migrainous headache, seizures, and stroke-like episodes. Stroke-like episodes are focal neurological deficits and one of the most common symptoms in MELAS patients, however their pathogenic mechanisms remain unknown. Here we report a case of stroke-like episodes in MELAS with a suggested association with neuronal hyperexcitability, one of the pathogenic theories.

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