Utilización de haloperidol en un paciente con síndrome de encefalomiopatía mitocondrial, acidosis láctica y episodios parecidos a ictus (síndrome MELAS)
- Fernando Acebrón Sánchez-Herrera 1
- Carla Anciones Martín 1
- Asier de Albóniga-Chindurza Barroeta 1
- Carlos Miguel Guirao Rubio 1
- Paula Pérez Torre 1
- Alicia Vives Luengo 3
- Iñigo Corral Corral 1
- Araceli Alonso Cánovas 1
- Javier Ortiz Rodríguez 2
- 1 Servicio de Neurología, Hospital Ramón y Cajal, Madrid, España
- 2 Servicio de Psiquiatría, Hospital Ramón y Cajal, Madrid, España
- 3 Servicio de Psiquiatría, Hospital Doctor Rodríguez Lafora, Madrid, España
ISSN: 1134-5934
Year of publication: 2015
Volume: 22
Issue: 3
Pages: 77-79
Type: Article
More publications in: Psiquiatría biológica: Publicación oficial de la Sociedad Española de Psiquiatría Biológica
Abstract
Mitochondrial encephalomyopathy with lactic acidosis and stroke-like episodes (MELAS) syndrome is a maternally inherited disease characterised by an anomaly in the mitochondrial respiratory chain complex. Apart from encephalopathy, myopathy and stroke-like episodes, these patients can also develop psychiatric symptoms such as dementia, affective disorders, psychosis, and anxiety phenomena. Because of the low prevalence of this syndrome, there are few references about the management of its psychiatric comorbidity. In mitochondrial diseases, neuroleptic agents are not recommended because they have demonstrated in vitro toxicity over the mitochondrial respiratory chain. The case is presented of a patient with a diagnosis of MELAS syndrome confirmed by the detection of a A3243G mutation in the MT-TL1 gene encoding part of the mitochondrial DNA. This patient did not only show the classic manifestations of the disease, but also presented with psychomotor agitation, insomnia and behavioural disturbances with aggressiveness. Several drugs were ineffective, but intravenous haloperidol induced remission without worsening of the neurological manifestations. This case suggests that haloperidol may be safe and effective for the acute control of psychiatric symptoms in mitochondrial syndromes.