Article Text
Statistics from Altmetric.com
A 19-year-old right-handed man was admitted because of prolonged somnolence after an epileptic seizure. He had no relevant medical or family history and no history of substance abuse. However, his early childhood development had been delayed, with him finding difficulty keeping up with other children during physical activity. On examination, he was sleepy but with no other neurological signs. MR scan of the brain showed multiple bihemispheric cortical FLAIR (fluid-attenuated inversion recovery) hyperintensities that were not confined to one single vascular territory (figure 1A). Electroencephalogram (EEG) showed reduced amplitude of the left occipital waveforms and left temporal slowing. His serum creatine kinase was elevated at 471 U/L (normal <190), and lactate was elevated in both plasma (2.8 mmol/L; normal 0.5–2.2) and cerebrospinal …
Footnotes
Contributors CEJD: drafting of the manuscript. CK, GF, HL, GW: critical revision of the manuscript.
Competing interests None declared.
Patient consent for publication Obtained.
Provenance and peer review Not commissioned; externally reviewed by Rhys Thomas, Newcastle-upon-Tyne, UK.
Data availability statement All data relevant to the study are included in the article or uploaded as online supplementary information.
Read the full text or download the PDF:
Other content recommended for you
- Cortical abnormalities on MRI: what a neurologist should know
- MELAS: a new disease associated mitochondrial DNA mutation and evidence for further genetic heterogeneity
- Can diffusion weighted magnetic resonance imaging help differentiate stroke from stroke-like events in MELAS?
- Mitochondrial encephalomyopathy with lactic acidosis and stroke-like episodes (MELAS) in the older adult
- Clinical mitochondrial genetics
- Status epilepticus caused by an unusual encephalopathy
- What to see when you are looking at confusion: a review of the neuroimaging of acute encephalopathy
- An MRI review of acquired corpus callosum lesions
- Mitochondrial disease: mimics and chameleons
- Stroke-like migraine attack after cranial radiation therapy: the SMART syndrome