Rasmussen's encephalitis (RE) is charac terised by refractory focal seizures, unilateral cortical deficits, and progressiveunihemispheric focal cortical atrophy of undetermined aetiology. A majority of these cases present in childhood, and three diseasestages have been recognised: a 'prodromal stage', an 'acute stage' and a 'residual stage'. Adult-onset and variant forms have alsobeen described but are rare, and we report one such case with frequent refractory focal seizures, right-sided hemiparesis, aphasia,and marked atrophy of the left perisylvian cortex with a slow disease progression over 17 years. Immunotherapy withcor ticosteroids, IVIG, plasma exchange, and tacrolimus has been tried in RE with variable results. Hemispherectomy anddisconnective techniques like functional hemispherectomy and hemispherotomy are effective in achieving seizure freedom in62.5% to 85% cases, but carry a risk of motor and language deficits
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