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We appreciated reading the article by Zhang et al about 10 patients were on mitochondrion-toxic AEDs. In the non-LEV group, 41 patients were on potentially mitoa retrospective study of 102 mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes (MELAS) chondrion-toxic AEDs. Four patients were even on a [1] patients with epilepsy in which disability and outcome were assessed (median follow-up: 4 years). Administration of levetirazetam (LEV) was associated with a better outcome compared to other antiepileptic drugs (AEDs). The study has several shortcomings requiring discussion.

Mortality in mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes does not depend on levetirazetam alone