Advertisement

Epileptic nystagmus in MELAS and non-mitochondrial disorders

      We eagerly read the article by Aykac et al. about 20 patients with horizontal epileptic nystagmus [
      • Aykac SC
      • Ekinci AS
      • Tabakoglu AY
      • Gulluoglu H
      • Aydogdu I
      • Bademkıran F
      • Uludag B
      • Arac N
      • Guler A.
      What does epileptic nystagmus show us in cases presenting acute neurological symptoms?.
      ]. One of these patients was reported as having mitochondrial encephalopathy, lactic acidosis, and stroke-like episodes (MELAS) syndrome [
      • Aykac SC
      • Ekinci AS
      • Tabakoglu AY
      • Gulluoglu H
      • Aydogdu I
      • Bademkıran F
      • Uludag B
      • Arac N
      • Guler A.
      What does epileptic nystagmus show us in cases presenting acute neurological symptoms?.
      ]. It was found that the ictal discharge pattern was rhythmic fast activity with a mean frequency of 15 Hz, that ictal discharges originated from the parieto-occipital, temporo-occipital, parieto-occipito-temporal, temporal, occipital, or centro-parietal areas, that the fast phase of the nystagmus was beating away from the side of ictal discharges, and that the origin of the ictal discharges was compatible with the lesion localization on cerebral magnetic resonance imaging (MRI) [
      • Aykac SC
      • Ekinci AS
      • Tabakoglu AY
      • Gulluoglu H
      • Aydogdu I
      • Bademkıran F
      • Uludag B
      • Arac N
      • Guler A.
      What does epileptic nystagmus show us in cases presenting acute neurological symptoms?.
      ]. The study is appealing but raises concerns.

      Keywords

      Abbreviations:

      MELAS (mitochondrial encephalopathym lactic acidosis, and stroke-like episodes), MID (mitochondrial disorder), MRI (magnetic resonance imaging), SLL (stroke-like lesion)
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Seizure - European Journal of Epilepsy
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Aykac SC
        • Ekinci AS
        • Tabakoglu AY
        • Gulluoglu H
        • Aydogdu I
        • Bademkıran F
        • Uludag B
        • Arac N
        • Guler A.
        What does epileptic nystagmus show us in cases presenting acute neurological symptoms?.
        Seizure. 2022; 101: 184-189https://doi.org/10.1016/j.seizure.2022.08.005
        • Al Yazidi G
        • Mulder J
        • Licht C
        • Harvey E
        • Robertson J
        • Sondheimer N
        • Tein I
        Reversal of Stroke-Like Episodes With L-Arginine and Meticulous Perioperative Management of Renal Transplantation in a Patient With Mitochondrial Encephalomyopathy, Lactic Acidosis and Stroke-Like Episodes (MELAS) Syndrome.
        Case Report. Neurohospitalist. 2022; 12: 67-73https://doi.org/10.1177/19418744211000512
        • Steriade C
        • Andrade DM
        • Faghfoury H
        • Tarnopolsky MA
        • Tai P.
        Mitochondrial encephalopathy with lactic acidosis and stroke-like episodes (MELAS) may respond to adjunctive ketogenic diet.
        Pediatr Neurol. 2014; 50: 498-502https://doi.org/10.1016/j.pediatrneurol.2014.01.009
        • Tarodo SG
        • Nguyen T
        • Ranza E
        • Vulliémoz S
        • Korff CM.
        A triad of infantile spasms, nystagmus and a focal tonic seizure.
        Epileptic Disord. 2018; 20: 295-300https://doi.org/10.1684/epd.2018.0984
        • Kaplan PW
        • Lesser RP.
        Vertical and horizontal epileptic gaze deviation and nystagmus.
        Neurology. 1989; 39: 1391-1393https://doi.org/10.1212/wnl.39.10.1391

      Linked Article