Functional hemispherotomy for Rasmussen encephalitis in a child: a case report

Background

Rasmussen’s encephalitis is a rare, progressive inflammatory disorder of the central nervous system characterized by unilateral hemispheric atrophy, pharmacoresistant focal seizures, and progressive neurological decline; however, the exact etiopathogenesis remains unclear. Case summary: We report on the case of a 6-year-old girl with no prior medical history who presented with a one-year history of refractory left hemicorporeal tonic seizures with left hemiparesis despite taking three antiepileptic medications. Electroencephalography and brain magnetic resonance imaging confirmed a diagnosis of Rasmussen’s encephalitis. The patient underwent a right functional hemispherotomy involving temporal lobectomy, subpial fronto-temporal resection, and hippocampal disconnection after failing medical therapy. There was complete resolution of seizures post-surgery; however, there was aggravation of the left hemiparesis.