Radiologic Findings in a Patient With Mitochondrial Encephalomyopathy With Lactic Acidosis and Stroke-Like Episodes Syndrome: A Case Report

Mitochondrial encephalomyopathy with lactic acidosis and stroke-like episodes (MELAS) syndrome is a rare, genetically inherited mitochondrial disorder that typically manifests in childhood. The most common radiologic features include basal ganglia calcification, atrophy, and stroke-like cortical lesions. We present the case of an 18-year-old female patient with no known medical history who arrived at the emergency department with altered mental status following a suicide attempt. The patient's initial workup, including a computed tomography (CT) scan of the brain, revealed abnormal findings, prompting further investigation into the patient's medical history. It was later discovered that the patient had a previous diagnosis of MELAS syndrome. This diagnosis helped explain both the radiologic abnormalities and her psychiatric symptoms. This case underscores the importance of recognizing radiologic presentations of rare conditions such as MELAS syndrome, which may contribute to the broader spectrum of clinical manifestations associated with the disease.