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(Stroke. 1995;26:1950-1952.)
© 1995 American Heart Association, Inc.

Articles

Evidence for Cardioembolic Stroke in a Case of Kearns-Sayre Syndrome

Christoph Kosinski, MD; Michael Mull, MD; Harald Lethen, MD Rudolf Töpper, MD

From the Departments of Neurology (C.K., R.T.), Neuroradiology (M.M.), and Cardiology (H.L.), Technical University of Aachen (Germany).

Background Cerebral infarction is a known complication in patients with mitochondrial encephalomyopathies (MELAS, MERRF, Kearns-Sayre syndrome), but the etiology in the different types remains uncertain.

Case Description A 33-year-old woman who had suffered from ophthalmoplegia, bilateral ptosis, ataxia, retinitis pigmentosa, and epilepsy since childhood was diagnosed to have Kearns-Sayre syndrome. The diagnosis was confirmed by muscle biopsy when she was 17 years old. A pacemaker was implanted because of the occurrence of bradyarrhythmias when she was 24 years old. The patient was admitted to the hospital with left-sided hemiparesis of sudden onset due to right striatocapsular infarction. Results of Doppler sonography of the carotid arteries were normal; however, transesophageal echocardiography revealed a thrombus in the left atrial appendage.

Conclusions Stroke in Kearns-Sayre syndrome is likely to be due to cardiac embolism. Anticoagulant therapy should be considered even for mild forms of cardiomyopathies leading to left ventricular dysfunction.

Key Words: cardioembolic stroke • echocardiography, transesophageal • etiology • MELAS syndrome

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