Rasmussen’s Encephalitis: A Case Report and Literature Review

Abstract

Here we present a case of a woman aged 23 years with a 10-year history of uncontrolled partial epilepsy with right-sided motor seizures, accompanied by a progressive weakness of the right side of the body of one-year duration. Magnetic resonance imaging revealed marked atrophy of the left cerebral cortex with ex-vacuo dilatation of the ipsilateral lateral ventricle. In view of the prolonged history of refractory right-sided partial motor seizures, right hemiparesis, and left-sided brain atrophy on imaging, a possibility of ‘adult-onset Rasmussen’s encephalitis (RE) was considered. RE is characterized by intractable focal onset seizures, namely epilepsia partialis continua, and deterioration of functions associated with the affected hemisphere, such as hemiplegia and progressive cognitive deterioration, in the majority of cases. It is common in children aged under 10 years with average age of disease onset at around 6 years, but it is uncommon in adults; the adult variant accounts for only about 10% of cases.