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.
|Autori:||Ng, Yi Shiau; Bindoff, Laurence A; Gorman, Gráinne S; Horvath, Rita; Klopstock, Thomas; Mancuso, Michelangelo; Martikainen, Mika H; Mcfarland, Robert; Nesbitt, Victoria; Pitceathly, Robert D S; Schaefer, Andrew M; Turnbull, Doug M|
|Titolo:||Consensus-based statements for the management of mitochondrial stroke-like episodes|
|Anno del prodotto:||2019|
|Digital Object Identifier (DOI):||10.12688/wellcomeopenres.15599.1|
|Appare nelle tipologie:||1.1 Articolo in rivista|