Presentation of adult mitochondrial epilepsy

Adult mitochondrial epilepsy appears to be less frequent than previously believed but the prevalence strongly depends on patient selection. Mitochondrial epilepsy is most frequently “structural/metabolic”. AEDs recommended for mitochondrial epilepsy include levetiracetam, lamotrigine, gabapentin and lacosamide. The outcome of mitochondrial epilepsy may be more favourable if mitochondrion-toxic AEDs are avoided. Only if non-mitochondrion-toxic AEDs are ineffective, mitochondrion-toxic AEDs may be used.