• Medicine · Feb 2020

    Case Reports

    Therapeutic management of stroke-like episodes varies from that of encephalitis.

    • Josef Finsterer.
    • Krankenanstalt Rudolfstiftung, Messerli Institute, Vienna, Austria.
    • Medicine (Baltimore). 2020 Feb 1; 99 (8): e19141e19141.

    IntroductionStroke-like episodes (SLEs) are typical cerebral manifestations of certain mitochondrial disorders (MIDs). They are characterised by a vasogenic edema in a non-vascular distribution. PATIENTS CONCERNS:: none DIAGNOSIS:: SLEs show up on cerebral MRI as stroke-like lesions (SLLs), characterised by vasogenic edema in a non-vascular distribution. SLLs expand in the acute stage and regress during the chronic stage. They show hyperperfusion in the acute stage and hypoperfusion in the chronic stage.InterventionsSLLs respond favorably to antiseizure drugs, to No-precursors, steroids, the ketogenic diet, and antioxidants.OutcomeSLLs end up as normal tissue, white matter lesion, grey matter lesion, cyst, laminar cortical necrosis, or the toenail sign.ConclusionsSLLs are a frequent manifestation of MIDs. They undergo dynamic changes in the acute and chronic stage. They need to be differentiated from ischemic stroke as they are differentially treated.

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