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Mitochondrial Encephalopathy with Lactic Acidosis and Stroke-like Episodes (MELAS)

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  • 40-year-old patient presented with acute onset of aphasia.
  • Initial MRI showed cortical and subcortical diffusion-weighted abnormality in the left anterior temporal lobe.
  • On follow-up imaging, this region of signal abnormality and swelling significantly increased. There was both restricted and facilitiated diffusion involving both cortex and subcortical white matter.