A case of rhabdomyolysis after status epilepticus without stroke-like episodes in mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episodes
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- Yokoyama Jun
- Department of Neurology, Neurological Institute, Graduate School of Medical Sciences, Kyushu University
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- Yamaguchi Hiroo
- Department of Neurology, Neurological Institute, Graduate School of Medical Sciences, Kyushu University
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- Shigeto Hiroshi
- Department of Neurology, Neurological Institute, Graduate School of Medical Sciences, Kyushu University
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- Uchiumi Takeshi
- Department of Clinical Chemistry and Laboratory Medicine, Graduate School of Medical Sciences, Kyushu University
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- Murai Hiroyuki
- Department of Neurology, Neurological Institute, Graduate School of Medical Sciences, Kyushu University
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- Kira Jun-ichi
- Department of Neurology, Neurological Institute, Graduate School of Medical Sciences, Kyushu University
Bibliographic Information
- Other Title
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- Stroke-like episodesを呈さずに痙攣重積と横紋筋融解症で発症したmitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episodes（MELAS）の1例
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Abstract
A 24-year-old man was referred to our hospital emergency department due to a sudden onset of convulsions after drinking. On arrival he presented status epilepticus and was managed by artificial ventilation. He had no brainstem signs or meningeal irritation. Head MRI showed an old infarction-like lesion in the left occipital lobe, but no abnormal signals on diffusion-weighted images. The patient showed acute rhabdomyolysis (CK 18,000 IU/l) and renal failure, and hemodialysis was started. On 18 day after admission, he was transferred to our department with mild proximal limb muscle weakness and bilateral sensorineural hearing impairment. Electroencephalography demonstrated diffuse intermittent slow wave activities. We suspected a mitochondrial disease because of a significant increase in the lactate/pyruvate ratio (24.1) in the spinal fluid, and identified A3243G mutations in mitochondrial DNA (heteroplasmy 20%) in peripheral white blood cells. We diagnosed his illness as mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episodes (MELAS). This is a rare case presenting an acute onset of rhabdomyolysis following alcohol intake related to A3243G mitochondrial mutation without preceding stroke-like episodes.
Journal
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- Rinsho Shinkeigaku
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Rinsho Shinkeigaku 56 (3), 204-207, 2016
Societas Neurologica Japonica