Ng, YS;
Bindoff, LA;
Gorman, GS;
Horvath, R;
Klopstock, T;
Mancuso, M;
Martikainen, MH;
... Turnbull, DM; + view all
(2019)
Consensus-based statements for the management of mitochondrial stroke-like episodes [version 1; peer review: 2 approved].
Wellcome Open Research
, 4
, Article 201. 10.12688/wellcomeopenres.15599.1.
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Abstract
BACKGROUND: Focal-onset seizures and encephalopathy are prominent features of a stroke-like episode, which is a severe neurological manifestation associated with subtypes of mitochondrial disease. Despite more than 30 years of research, the acute treatment of stroke-like episodes remains controversial. METHODS: We used the modified Delphi process to harness the clinical expertise of a group of mitochondrial disease specialists from five European countries to produce consensus guidance for the acute management of stroke-like episodes and commonly associated complications. RESULTS: Consensus on a new definition of mitochondrial stroke-like episodes was achieved and enabled the group to develop diagnostic criteria based on clinical features, neuroimaging and/or electroencephalogram findings. Guidelines for the management of strokelike episodes were agreed with aggressive seizure management strongly recommended at the outset of stroke-like episodes. CONCLUSIONS: Our consensus statement defines stroke-like episodes in terms of an epileptic encephalopathy and we have used this to revise both diagnostic criteria and guidelines for management. A prospective, multi-centre, randomised controlled trial is required for evaluating the efficacy of any compound on modifying the trajectory of stroke-like episodes.
| Type: | Article |
|---|---|
| Title: | Consensus-based statements for the management of mitochondrial stroke-like episodes [version 1; peer review: 2 approved] |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.12688/wellcomeopenres.15599.1 |
| Publisher version: | https://doi.org/10.12688/wellcomeopenres.15599.1 |
| Language: | English |
| Additional information: | © 2019 Ng YS et al. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/). |
| Keywords: | MELAS, m.3243A>G, POLG, epilepsy, status epilepticus, encephalopathies, stroke, neurodegenerative disorders (other than dementia), antiepileptic drugs |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology > Department of Neuromuscular Diseases |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10088813 |
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