alexa Dangers of Cocaine Ingestion in MELAS Syndrome
ISSN: 2165-7548

Emergency Medicine: Open Access
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Case Report

Dangers of Cocaine Ingestion in MELAS Syndrome

G O’Connor1*, C Doherty2, J Meaney3 and G Mc Mahon1

1Emergency Department, St. James’s Hospital, James’s Street, Dublin 8, Ireland

2Department of Neurology, St. James’s Hospital, James’s Street, Dublin 8, Ireland

3Radiology Department, St. James’s Hospital, James’s Street, Dublin 8, Ireland

*Corresponding Author:
O’Connor G
Emergency Department, St. James’s Hospital
James’s Street, Dublin 8, Ireland
Tel: (01) 416 2774 or (01) 416 2775
E-mail: [email protected]

Received Date: May 23, 2013; Accepted Date: July 16, 2013; Published Date: July 18, 2013

Citation: O’Connor G, Doherty C, Meaney J, Mc Mahon G (2013) Dangers of Cocaine Ingestion in MELAS Syndrome. Emergency Med 3:145. doi:10.4172/2165-7548.1000145

Copyright: © 2013 O’Connor G, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.



The genetic metabolic disorder known as Mitochondrial Myopathy, Encephalopathy, Lactic Acidosis, and Stroke- Like Episodes (MELAS) is characterised by mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episodes and is also associated with epilepsy. Pathogenesis is driven by a chronic state of energy failure, but is poorly understood with at least two hypotheses. The angiopathy (ischaemic) hypothesis suggests the presence of abnormal mitochondria in vascular endothelial cells, while the cytopathy hypothesis is thought to involve neuronal hyperexcitability, resulting in prolonged epileptic seizure activity and vasogenic oedema. We present an acute case of recurrent seizures and severe lactic acidosis precipitated by cocaine use in a patient with MELAS syndrome. The triad of lactic acidosis, seizures, and stroke-like episodes focus on the diagnosis. The neurological complications are probably precipitated by oxidative stress.

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