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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.

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  • A 30-year-old patient presented with a 1 week history of word finding difficulty followed by a seizure.
  • MRI showed cortical diffusion restriction variably affecting the cortex and subcortical white matter of the left cerebral hemisphere.
  • The region of abnormality increased over the 3 weeks.