Evolution of Brain Imaging Abnormalities in Mitochondrial Encephalomyopathy with Lactic Acidosis and Stroke-Like Episodes

Mitochondrial encephalomyopathy with lactic acidosis and stroke-like episodes often presents as acute visual field loss, which may be initially misattributed to stroke. Although a characteristic spectrum of imaging and chemistry abnormalities should alert to its diagnosis and early therapeutic intervention, an often underappreciated degree of disease heterogeneity can complicate the clinical presentation.