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