Clinical analysis of 8 cases of MELAS syndrome that misdiagnosed as herpes simplex virus encephalitis / 临床神经病学杂志

ABSTRACT

Objective To analyze clinical characteristics of 8 cases of MELAS syndrome that misdiagnosed as herpes simplex virus encephalitis(HSE).Methods The clinical data of 8 cases of MELAS syndrome that misdiagnosed as HSE were reviewed retrospectively.Results The main manifestations of 8 cases were repeated fever,progressive mental impairment,seizures,headache,descent of eyesight and hearing,weakness of extremities.Fever was the common symptom in the 8 cases.Exercise tolerance dose of serum lactic acid levels studied in 8 cases were obviously abnormal.Imaging examinations showed laminar necrosis or atrophy in brain lobes and basal ganglia areas.Electroencephalogram(EEG) mainly showed diffused slow waves,1 patient displayed myogenic injury in electromyogram(EMG).Muscle biopsy showed red ragged fibers and abnormal mitochondria in all cases.Conclusions The clinical manifestations of MELAS syndrome are similar to HSE,but EEG and imaging results are obviously different from HSE.Exercise tolerance dose of serum lactic acid and muscle biopsy are important for diagnose of MELAS syndrome.