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  • Updated 03.12.2017
  • Released 10.09.2011
  • Expires For CME 03.12.2020

Epilepsy in mitochondrial disorders

Introduction

Overview

Mitochondrial diseases that arise from defects in the respiratory chain, the metabolic pathway that produces ATP, are potent causes of epilepsy and are usually part of a syndrome, eg, myoclonus epilepsy with ragged-red fibers (MERRF) or mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes (MELAS). The seizures can be focal or generalized and show a predilection for the occipital lobes, and there is a high risk of status epilepticus. In this clinical article the author reviews the types of mitochondrial disease commonly associated with epilepsy and the seizures that are known to occur.

Key points

• Mitochondrial dysfunction is a potent cause of epilepsy, and status epilepticus can be the presenting feature.

• Both partial and generalized epilepsy and myoclonus occur in mitochondrial disease.

• Mitochondrial epilepsy shows predilection for the occipital lobes.

• Sodium valproate is absolutely contraindicated in patients with mitochondrial epilepsy caused by POLG mutations.

Historical note and terminology

The historical note and nomenclature for specific mitochondrial disorders is discussed in their respective sections.

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