is one of the most frequently occurring mitochondrial disorders and is most commonly caused by an A-to-G transition mutation at the 3243 position of the mitochondrial genome.
I had never before had an experience with a MELAS syndrome
patient, although I have experience in treating another fatal mitochondrial disease, amyotrophic bilateral sclerosis, with some relative success but accompanied by the incapacity of the patients to pursue the treatment.
With the consent of the patient, we present a case of a 33-year-old male with MELAS syndrome
who had successful spinal anaesthesia for surgical fixation of a left subcapital femur fracture.
Mitochondrial encephalopathy, lactic acidosis, and strobelibe episodes: basic concepts, clinical phenotype, and therapeutic management of MELAS syndrome
. Ann N Y Acad Sci 2008; 1142: 133-158.
The differential diagnosis includes a host of sporadic and familial conditions associated with strokes, such as coagulopathy (ie, thrombotic thrombocytopenic purpura), MELAS syndrome
(mitochondrial myopathy, encephalopathy, lactic acidosis, and strokelike episodes), abnormal lipoproteinemias, cerebral amyloid angiopathy, Fabry disease, and homocystinuria.