Progression of stroke-like lesions along the cortico-ponto-cerebellar tract

Excerpt

Mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episodes (MELAS) is a maternally-inherited mitochondrial disorder. Prognosis of patients suffering from MELAS syndrome depends on the severity and the frequency of the stroke-like episodes (SLEs). Two opposite theories have been proposed to explain the pathogenesis of SLE: (1) the mitochondrial angiopathy theory, which suggests a predominant ischemic mechanism; and (2) the mitochondrial cytopathy theory, which is based on neuronal mitochondrial energy failure [1]. In the present case of MELAS syndrome, MRI and electroencephalogram findings further support that epilepsy plays a key role in the energy balance decompensation and subsequent spreading of the SLE. …