Table 1 Literature review of MELAS syndrome masquerading as acute encephalitis
Author (year) | Age/Sex | Symptoms at onset | Focus on MRI | CSF cell (/mm3)/ protein (mg/dL)/lactic acid (mg/dL) | Treatment | mtDNA mutation | References |
|---|---|---|---|---|---|---|---|
Johns DR (1993) | 41/F | Headache, seizure | Lt. temporal lesion with edema and mass effect | ND | ACV, DXA, PHT | 3243 | 11 |
44/M | Lt. visual field defect, apraxia of the Lt. limbs, dressing apraxia | Rt. temporoparietal lesion | Acellular/100/ND | ACV, PHT | 3243 | ||
16/F | Confusion, visual difficulties, severe headache, nausea, vomiting | Lt. occipital lesion | 2/36/ ND | ACV | 3243 | ||
Sharfstein SR (1999) | 55/F | Aphasia, delirium | Edema in the Lt. temporal and parietal lobes | 3/63/ ND | ACV, PHT | 3243 | 12 |
Hsu YC (2012) | 47/M | Acute onset pyrexia, headache, generalized seizure, agitation | Unremarkable | 7750/431.8/ND | CTRX, VCA, VPA → PHT | 3243 | 13 |
Gieraerts C (2013) | 36/M | Anomic aphasia, difficulties of comprehension | Both temporal lobes, insular regions, posterior straight, and cingulate gyri with sparing of the lentiform nuclei | Normal cells/65.8/46.9 | ACV | 3243 | 14 |
Gooriah R (2015) | 29/M | Gradual onset of confusion, headache, irritability, personality change, tonic-clonic seizures, pyrexia | Rt. temporoparietal region, Rt. insular cortex and the pole of the Lt. temporal lobe | 1/62/ ND | ACV | 3243 | 15 |
Caldarazzo Ienco E (2016) | 45/M | Confusion, headache, generalized seizures | Both temporal lobes | Normal cells/ 83/80 | Antiviral, antibiotic therapy, corticosteroid, → carnitine, CoQ10 | 3243 | 16 |
Present case | 74/M | Acute cognitive impairment, psychosis, headache, pyrexia | Rt. parieto-temporal areas | 26/70/58.0 | ACV, mPSL, → CoQ10, L-arginine, Vitamin B1 | 14453 | Present study |