{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T10:42:26Z","timestamp":1784025746619,"version":"3.55.0"},"reference-count":15,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2022,2,2]],"date-time":"2022-02-02T00:00:00Z","timestamp":1643760000000},"content-version":"vor","delay-in-days":1,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Case Reports"],"published-print":{"date-parts":[[2022,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Mitochondrial encephalopathy, lactic acidosis, and stroke\u2010like episodes (MELAS) is characterized by metabolic stroke, seizures, cognitive decline, lactic acidosis, ragged\u2010red fibers, headache, and vomiting, and in 80% of cases due to the mtDNA variant m.3243A&gt;G. We report the case of a MELAS patient carrying a variant in subunit\u20105 of the respiratory chain (<jats:italic>MT<\/jats:italic>\u2010<jats:italic>ND5<\/jats:italic>), rarely reported in MELAS. The patient is a 33\u2010year\u2010old male, who experienced a series of stroke\u2010like episodes (StLEs) since age 23\u00a0years, which manifested clinically as seizures transient sensory disturbances, weakness, and visual or cognitive impairment. Over 9\u00a0years, these StLEs were misinterpreted as ischemic strokes, respectively, as cerebral vasculitis. He presented with mild, recurrent elevations of the creatine kinase. Initially, anti\u2010seizure drugs and steroids appeared to be beneficial. Despite good recovery of each single StLE, the patient experienced a progressive decline of cognitive functions and activities of daily living. Cerebral imaging showed corresponding stroke\u2010like lesions in changing locations. At age 32y, genetic work\u2010up revealed the variant m.13513G&gt;A in <jats:italic>MT<\/jats:italic>\u2010<jats:italic>ND5<\/jats:italic>. The patient profited significantly from a cocktail with anti\u2010oxidants\/cofactors. This case shows that the variant m.13513G&gt;A in <jats:italic>MT<\/jats:italic>\u2010<jats:italic>ND5<\/jats:italic> can manifest as MELAS that StLEs recover spontaneously and that the course of MELAS is slowly progressive.<\/jats:p>","DOI":"10.1002\/ccr3.5361","type":"journal-article","created":{"date-parts":[[2022,2,3]],"date-time":"2022-02-03T05:53:21Z","timestamp":1643867601000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["MELAS with multiple stroke\u2010like episodes due to the variant m.13513G&gt;A in <i>MT\u2010ND5<\/i>"],"prefix":"10.1002","volume":"10","author":[{"given":"Ritwik","family":"Ghosh","sequence":"first","affiliation":[{"name":"Department of General Medicine Burdwan Medical College &amp; Hospital Burdwan West Bengal India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Souvik","family":"Dubey","sequence":"additional","affiliation":[{"name":"Department of Neuromedicine Bangur Institute of Neurosciences Institute of Postgraduate Medical Education and Research &amp; SSKM Hospital Kolkata West Bengal India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Subhas","family":"Bhuin","sequence":"additional","affiliation":[{"name":"Department of Neuromedicine Bangur Institute of Neurosciences Institute of Postgraduate Medical Education and Research &amp; SSKM Hospital Kolkata West Bengal India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Durjoy","family":"Lahiri","sequence":"additional","affiliation":[{"name":"Department of Neuromedicine Bangur Institute of Neurosciences Institute of Postgraduate Medical Education and Research &amp; SSKM Hospital Kolkata West Bengal India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Biman Kanti","family":"Ray","sequence":"additional","affiliation":[{"name":"Department of Neuromedicine Bangur Institute of Neurosciences Institute of Postgraduate Medical Education and Research &amp; SSKM Hospital Kolkata West Bengal India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2839-7305","authenticated-orcid":false,"given":"Josef","family":"Finsterer","sequence":"additional","affiliation":[{"name":"Neurology Neurology &amp; Neurophysiology Center vienna \u00d6sterreich Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,2,2]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ymgme.2015.06.004"},{"key":"e_1_2_10_3_1","first-page":"619","article-title":"MELAS: a nationwide prospective cohort study of 96 patients in Japan","volume":"2012","author":"Yatsuga S","year":"1820","journal-title":"Biochim Biophys Acta"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/0960-8966(92)90045-8"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-8749.2010.03907.x"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0039-1691812"},{"key":"e_1_2_10_7_1","first-page":"312","article-title":"Two new cases of Leigh syndrome caused by mutation m.13513G> A in the MTND5 gene","volume":"68","author":"Jimenez\u2010Legido M","year":"2019","journal-title":"Rev Neurol"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-1789.2010.01115.x"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jns.2019.03.021"},{"key":"e_1_2_10_10_1","first-page":"130","article-title":"Clinical, pathological and molecular biological characteristics of mitochondrial encephalomyopathy with lactic acidosis and stroke\u2010like episode in children","volume":"51","author":"Liu XL","year":"2013","journal-title":"Zhonghua Er Ke Za Zhi"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pediatrneurol.2017.12.005"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/1531\u20108249(200101)49:1<106:aid\u2010ana16>3.0.co;2\u2010t"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2021.601307"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.11622\/smedj.2015026"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598\u2010017\u201015871\u2010y"},{"issue":"7","key":"e_1_2_10_16_1","first-page":"312","article-title":"Dos nuevos casos de sindrome de Leigh por mutacion m.13513G>A en el gen MTND5 Two new cases of Leigh syndrome caused by mutation m.13513G> A in the MTND5 gene","volume":"68","author":"Jimenez\u2010Legido M","year":"2019","journal-title":"Rev Neurol"}],"container-title":["Clinical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccr3.5361","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ccr3.5361","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccr3.5361","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,27]],"date-time":"2023-08-27T13:12:19Z","timestamp":1693141939000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ccr3.5361"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,2]]},"references-count":15,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2022,2]]}},"alternative-id":["10.1002\/ccr3.5361"],"URL":"https:\/\/doi.org\/10.1002\/ccr3.5361","archive":["Portico"],"relation":{},"ISSN":["2050-0904","2050-0904"],"issn-type":[{"value":"2050-0904","type":"print"},{"value":"2050-0904","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,2]]},"assertion":[{"value":"2020-10-16","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-12-27","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-02-02","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e05361"}}