The article discusses a case of a 45-year-old male suspected of developing Parkinson's disease (PD) following SARS-CoV-2 infection. However, the authors raise doubts about the causal relationship, noting negative CSF results for the virus and limited evidence in dopaminergic neurons. They suggest that the patient's medication, particularly labetalol, may have triggered PD development, highlighting the need for further research. The article underscores the importance of considering alternative triggers for PD in COVID-19 patients and calls for more studies to establish a definitive link between SARS-CoV-2 and PD.

The review by Margolin (2020) explores the causes, work-up, and treatment options for diplopia (double vision). While highlighting the importance of thorough history-taking and basic examination skills in diagnosing diplopia, the review overlooks several disorders that can manifest with diplopia, including myopathy of extraocular muscles. The author suggests that a wider range of conditions, such as metabolic myopathy and immune-mediated neuropathies, should be considered in the differential diagnosis. The review emphasizes the need for a comprehensive work-up to include these often-neglected causes of diplopia, as early identification and treatment can lead to better outcomes.

The histological and immune-histological findings of islet cells in two patients with mitochondrial diabetes, one with MELAS syndrome and the other with MERRF syndrome. They observed that the severity of diabetes correlated with the histological findings on autopsy. However, the authors raise several concerns regarding the conclusions drawn. They argue that the differences in histology could be attributed to the distinct genotypes of MELAS and MERRF, rather than solely reflecting the severity of diabetes. They also suggest that other factors such as heteroplasmy rates, mtDNA copy numbers, and the presence of co-morbidities should be considered. Additionally, they question whether atrophy of islet cells necessarily indicates reduced insulin production and call for further investigation into serum insulin and C-peptide levels. Overall, the study highlights the need for a more comprehensive understanding of the genetic and clinical factors influencing diabetes severity in mitochondrial disorders.

On the diagnostic work-up of mitochondrial disorders using next-generation sequencing (NGS). The critique questions the efficacy of bigenomic sequencing (BGS) as a first step in investigating suspected MIDs, citing low confirmation rates and new diagnoses. It also raises concerns about the selection of patients for NGS, discrepancies in diagnostic criteria, and terminology errors in the study. Overall, the critique emphasizes the need for a comprehensive diagnostic approach combining NGS with traditional methods due to the limitations of NGS in diagnosing MIDs.

This case report describes a 50-year-old female with MELAS syndrome predominantly manifesting as intestinal pseudo-obstruction (IPO) and progressing rapidly to multiorgan failure. The report highlights the need for a comprehensive understanding of MELAS manifestations beyond the gastrointestinal tract, emphasizing the importance of investigating other organ involvement to assess disease progression accurately and predict outcomes. The association between IPO and stroke-like episodes (SLEs) is also discussed, suggesting a potential trigger effect of IPO on SLEs, which warrants further investigation.