SERIAL IMAGING IN MELAS

We report two patients with fatal mitochondrial myopathy, encephalopat hy, lactic acidosis, and stroke-like episodes (MELAS). Single-photon e mission computed tomography (SPECT) with I-123-N-iso-propyl-p-iodoamph etamine was more sensitive to the lesions than CT or MRI. SPECT showed focal hyperperfusion before or during the stroke and diffuse hypoperf usion of the brain, sparing the basal ganglia in the terminal stages. These findings support the theory that metabolic disturbance in the br ain causes the ''stroke'' in MELAS.