Dental treatment for a MELAS patient with type 1 diabetes mellitus with masticatory muscle disorders: A case report

The syndrome of mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes (MELAS) is a multiorgan disease that develops mainly in childhood and is a type 1 progressive mitochondrial encephalomyosis. Its clinical features include multiple cerebral infarctions, progressive muscle weakness, peripheral neuropathy such as numbness in the hands and feet, endocrine symptoms, sensorineural hearing loss, intellectual regression, and many other symptoms due to mitochondrial genetic abnormalities. Because of the wide variety of systemic symptoms, it takes time to reach a diagnosis. There is no clear cure, and it is recognized as a disease with a poor prognosis. There are reports of a decrease in general muscle strength, but there have been a few reports of symptoms around the oromaxillofacial area. In this study, a patient with type 1 diabetes mellitus whose jaw position was unstable due to a decrease in the strength of the masticatory muscles thought to be caused by MELAS underwent systemic management in cooperation with internal medicine, tooth extraction under local anesthesia, and then all-jaw oral function management, with a good course. The volume and form of meals improved. The patient received regular oral care after dental treatment, but then refused dental treatment. After that, the patient's general condition rapidly deteriorated, and he died due to multiple organ failure.

Automated summary

Mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes (MELAS) is a progressive mitochondrial disease characterized by multiple cerebral infarctions, muscle weakness, neuropathy, intellectual regression, and other symptoms. This study reports a case of a diabetic patient with MELAS who underwent oral treatment for weakened facial muscles, showing good progress initially but later refusing treatment and experiencing rapid deterioration leading to death.