a mitochondrial disorder in a middle age iranian patient: report of a rare case

Introduction: mitochondrial encephalopathy, lactic acidosis, and stroke-like episodes (melas) can involve multiple systems and cause stroke-like episodes and status epilepticus. case presentation: a 48-year-old female with history of early fatigability, migraine-type headaches, and bilateral sensory-neural hearing loss presented 3 episodes of serial seizures. on admission she was affected by wernicke aphasia and, then, right hemiparesis. investigations showed elevated arterial lactate and ragged red fibers on muscle biopsy. conclusion: though more commonly diagnosed during childhood, some cases of adult-onset melas syndrome are reported. this syndrome should be considered in patients with stroke-like events in adults without cerebrovascular risk factors and difficult-to-treat seizures.