Magnetic resonance imaging with fluid-attenuated inversion recovery pulse sequences in MELAS syndrome

We report the brain magnetic resonance imaging findings in the case of a 5-year-old boy with mitochondrial myopathy, encephalopathy, lactic acidosis and stroke-like episodes (MELAS). Fluid-attenuation inversion recovery (FLAIR) imaging revealed multifocal abnormal cortical signals which were difficult to see on conventional T1- and T2-weighted images. Although the patient was in an advanced clinical stage of disease and had severe cortical atrophy, FLAIR imaging demonstrated characteristic findings of MELAS.