%0 Journal Article %T Consensus-based statements for the management of mitochondrial stroke-like episodes. %A Ng YS %A Bindoff LA %A Gorman GS %A Horvath R %A Klopstock T %A Mancuso M %A Martikainen MH %A Mcfarland R %A Nesbitt V %A Pitceathly RDS %A Schaefer AM %A Turnbull DM %J Wellcome Open Res %V 4 %N 0 %D 2019 %M 32090171 暂无%R 10.12688/wellcomeopenres.15599.1 %X 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.