Case Reports in Neurological Medicine / 2019 / Article / Tab 1

Case Report

MELAS Missed for Years: Stroke-Like Lesions Are No Indication for Brain Biopsy

Table 1

Disease trajectory of the presented patient.

Onset, ageManifestationTherapy

16 yCollapse with TBI (petrous bone fracture)Conservative
23 yRight bimalleolar fractureNp
Until 38 yChronic alcoholismWithdrawal
39 yIcterus, hepatopathyNone
43 ySmall breastsBreast silicon implants
45–46 yRelapse of alcoholismSuccessful withdrawal
46 yEpilepsy with focal and generalized seizuresLevetiracetam
46 y1 SLL with intralesional bleeding (right occipital) hemianopia and neglect to the left, psychosisNeuroleptics
46 yHepatopathy, steatosis hepatisNone
Until age 46 ySmokingWithdrawal
46 yAcne rosaceaTopic ointments
46 yArachnoidal cyst (left temporo-basal)None
46 yFolic acid deficiencyFolic acid
46 yHyperlipidemiaDiet
46 y2 SLE (left occipital (epilepsy, psychosis, cortical blindness, and optic hallucinations))Brain biopsy via drill-hole quetiapin
47 yArterial hypertensionBisoprolol
47 yAV-block-1None
47 yHyponatremia after adding OXCOXC replaced with CBZ
Since age 47 yThrombocytopenia after adding CBZCBZ withdrawal
47 yMyoclonic seizureLevetiracetam
49 yGlaucomaLatanoprost
Until 49 yRecurrent syncopes due to sinus arrestsPacemaker
49 yHyperthyroidismNone
53 yCapsular fibrosisReplacement of breast implants
53 yIschemic strokes (PCAS territory, PCAS stenosis)Antithrombotics
56 yBarrett esophagusEsomeprazole
56 yHyperostosis frontalisNone
56 yGeneralized brain atrophyNone
Since yearsCarpopedal spasmsMagnesium
Since yearsHypoacusisNone

PCAS: left posterior cerebral artery syndrome, PRES: posterior reversible encephalopathy syndrome, SLE: stroke-like episode, AEDs: antiepileptic drugs, SSS: sick-sinus syndrome, TBI: traumatic brain injury, CBZ: carbamazepine, and np: not provided.

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