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Diffuse left sided hemiatrophy with encephalomalacia and gliotic changes are seen. Severe left ex vacuo ventriculomegaly is also noted. Overlying cranial bone has normal thickness.
These changes are in-keeping with Rasmussen encephalitis.
Chronic focal encephalitis (Rasmussen encephalitis) is a chronic inflammatory disease of unknown origin, usually affecting one cerebral hemisphere. It can occur in children under 10 years 1. The patients referred with epilepsia partialis continua or generalized status epilepticus 2.
The main differential diagnoses to be considered include:
- 1. Tien RD, Ashdown BC, Lewis DV, Atkins MR, Burger PC. Rasmussen's encephalitis: neuroimaging findings in four patients. (1992) AJR. American journal of roentgenology. 158 (6): 1329-32. doi:10.2214/ajr.158.6.1590136 - Pubmed
- 2. Rasmussen T, Olszewski J, Lloyd Smith D. Focal seizures due to chronic localized encephalitis. (1958) Neurology. 8 (6): 435-45. Pubmed