Case 051124 "MELAS"

13:24| A CASE RECORD OF THE MASSACHUSETTS GENERAL HOSPITAL describes a 61-year-old who was admitted to the hospital because of a seizure and altered mental status.
 The patient had been in good health, with the exception of mild hypertension for which she took no medications.
 On the morning of admission, her husband awoke at 4 a.m. to find her thrashing in bed, with rhythmic movements of all four extremities, for two to five minutes. She subsequently appeared groggy but alert, with a facial droop, garbled speech, and an inability to follow verbal commands.
 For the next six months, she remained aphasic and confused. During first hospitalization, the neuroimaging findings confirmed the clinical localization of the left temporo-occipital lesion, and its characteristics suggested focal metabolic dysfunction.
This neurologic syndrome occurred in the context of a urinary tract infection, and lumbar puncture revealed only elevated lactate levels, without evidence of a central nervous system infection or inflammatory response.
 Dr. Bradford Dickerson discusses differential diagnosis and management of this patient. [Original Article]

Vocabulary:

• groggy ふらふらした（グロッキーの元の語）
• garbled 不明瞭な(「文字化け」の意味もある）

Further Reading:

• Gene Reviews Japan "MELAS"