Clinical Review
Mitochondrial Myopathy, Encephalopathy, and Lactic Acidosis with Stroke-like Episodes Syndrome
Case in Point
Fed Pract. 2009 November;26(11):24
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David B. Sommer, MD, MPH, Susan M. Rakley, MD, and Richard S. Bedlack, MD, PhD
Dr. Sommer is a movement disorders fellow in the division of neurology at Duke University Medical Center (DUMC), Durham, NC. Dr. Rakley is a primary care physician at Durham VA Medical Center (DVAMC), Durham, NC. Dr. Bedlack is the section chief of neurology at DVAMC and an associate professor of medicine in the division of neurology at DUMC.
A presentation of altered mental status, nausea, vomiting, gait difficulty, and a left homonymous hemianopia, in the context of a long history of metabolic and neurologic problems, led clinicians to investigate an underlying mitochondrial disorder. This case highlights the clinical findings that should raise suspicion for these elusive conditions.