Stroke in mitochondrial encephalopathy, lactic acidosis, and stroke-like episodes is a vasogenic edema and not ischemic

Introduction: there is no common sense how to diagnose and treat stroke-like episodes in mitochondrial encephalopathy, lactic acidosis, and stroke-like episodes Aims: to discuss some shortcomings of a previously published paper about a 48yo female with MELAS. Methods: commentary Conclusion: the report could be more meaningful if the diagnosis would have been confirmed genetically, if NO-precursors would have been administered for the SLE, if possible, triggers of the SLE would have been discussed, and if the patient would have been prospectively investigated for subclinical or mildly manifesting abnormalities. Keywords: Mitochondrial; Stroke-like episode; Stroke-like lesion; NO-precursor