Disseminated small cortical lesions of stroke-like episodes in a patient with MELAS with an m.3271 T > C mutation

Little is known about magnetic resonance imaging findings in patients with mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episodes (MELAS) with the m.3271 A > G mutation. A 31-year-old man presented with headache and left-sided homonymous hemianopsia. Brain magnetic resonance imaging showed hyperintensities in the right occipital lobe on diffusion- and T2-weighted imaging. MELAS was diagnosed, and the etiological mutation was identified as m.3271 T > C. Although his symptoms gradually resolved, magnetic resonance imaging revealed disseminated small cortical lesions in the left occipital lobe. We report a rare case of atypical stroke-like lesions in a patient with MELAS with the m.3271 T > C mutation.