Two stroke-like episodes then a grand mal seizure occurred within nin
years in a 42-year-old patient. Neuroradiological findings (CT-scan an
d MRI) led to the diagnosis of incomplete MELAS syndrom. MRI with T2-w
eighted images (TR: 1 000ms; TE:35ms) showed two small asignal lesions
possibly resulting from hemosiderine. Metabolic studies are required
to help decide on muscular biopsies. Histological findings are needed
for diagnosis of this form of mitochondrial cytopathy with only stroke
-like manifestations.