On the other hand, the early onset of the migraine symptoms may also indicate the other potential genetic-related ischemic encephalopathies, such as mitochondrial encephalomyopathy, lactic-acidosis, stroke-like episodes (MELAS, caused by MTTL1 mutation), familial hemiplegic migraine (FHM, caused by CACNA1/ATP1A2/SCN1A mutations) and Retinopathy, vascular, cerebral and renal involvement, Raynaud and migraine attacks (HERNS, caused by TREX1 mutation) [33]. Here, MT-TL1 is linked to lactic acidosis.