Rasmussen's encephalitis

Case contributed by Dr Mostafa Mahmoud El Feky

Presentation

Seizures

Patient Data

Age: 5
Gender: Male
MRI

MRI brain

Mild diffuse uniform atrophic changes of the left cerebral hemisphere manifested as deepening of cortical sulci and mildly decreased volume of cortex and white matter. This is associated with mild exvaccu dilatation of the left lateral ventricle. Mild diffuse T2 and FLAIR hyperintensity is noted affecting the white matter of the left cerebral hemisphere. Mild attenuation of the left middle cerebral artery is also noted.

Preserved volume and MRI features of both cerebellar hemispheres.

Case Discussion

The described features of this case, as well as the clinical presentation of seizures, are suggestive of Rasmussen's encephalitis. It is believed to be a chronic viral infection of the brain affecting only one hemisphere with unilateral cerebral hemiatrophy resulting in drug-resistant epilepsy, and progressive neurological and cognitive deterioration.

Differential diagnosis of similar brain morphology:

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Case information

rID: 55374
Case created: 31st Aug 2017
Last edited: 6th Nov 2017
Inclusion in quiz mode: Included
Institution: DAR ELASHAA center

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