Abstract
Rasmussen’s encephalitis is a devastating illness characterized by intractable focal
seizures due to chronic localised encephalitis. We report on a rare variant of delayed
onset Rasmussen’s encephalitis with triple pathology. A 27-year-old male, who was
initially diagnosed with seizures when he was 16 years old, presented with focal seizures
that became refractory to multiple anticonvulsants. Multiple investigations, including
subdural electrode monitoring, revealed foci of onset in the right frontotemporal
region. The patient underwent right front-temporal lobectomy. Post-operatively, the
seizures became more severe and he developed new epilepsia partialis continua. Treatment
with intravenous immunoglobulin was unsuccessful. He subsequently underwent a right
hemispherectomy that rendered him seizure free. The three pathologies identified were
old ischemic changes, type II cortical dysplasia and stage II Rasmussen’s encephalitis.
Keywords
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Article info
Publication history
Accepted:
February 20,
2009
Received:
January 13,
2009
Identification
Copyright
© 2009 Elsevier Ltd. Published by Elsevier Inc. All rights reserved.
