Mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes (MELAS) syndrome (m.3243A>G tRNALeu (UUR) in MT-TL1 gene) (OMIM # 590050) [1] is associated with failure to thrive, lactic acidosis, neuromyopathy, epilepsy, migraine-like headaches and recurrent stroke-like episodes (SLEs) resembling vaso-occlusive strokes [2]. The gene discussed is MCAT; the disease is lactic acidosis.