Some mitochondrial disorders such as mitochondrial myopathy, encephalopathy, lactic acidosis and stroke-like episodes (MELAS) due to point mutations in mitochondrial tRNA; long-chain 3-hydroxyacyl-CoA dehydrogenase (LCHAD) or combined mitochondrial trifunctional protein (MTP) deficiency due to mutations in MTP (84); medium-chain acyl-CoA dehydrogenase deficiency (MCADD) due to mutations in the ACADM gene (85, 86). The gene discussed is HADHA; the disease is MELAS.