Early add-on immunoglobulin administration in Rasmussen encephalitis: the hypothesis of neuroimmunomodulation

Med Hypotheses. 2011 Nov;77(5):917-20. doi: 10.1016/j.mehy.2011.08.011. Epub 2011 Aug 31.

Abstract

Rasmussen encephalitis (RE) is a chronic inflammatory disease leading to unilateral hemispheric atrophy, associated with progressive neurological dysfunction and intractable seizures. The best approach to RE is hemispherectomy. However long-term immunotherapy seems to prevent or slow down hemispheric tissue loss and the associated functional decline. We describe a girl with epilepsia partialis continua (EPC) and progressive neurological dysfunction compatible with RE. The brain MRI showed a lesion that was initially interpreted as focal cortical dysplasia. Combined antiepileptic and immunomodulation were administered for two years with initial beneficial effects. The follow-up MRI, 4 year later showed. atrophic change in right parietal region. The association of antiepileptic and immunomodulation therapies may inhibit pathogenetic mechanisms responsible for neuronal loss in RE, slowing down the progression of the disease.

Publication types

  • Case Reports

MeSH terms

  • Anticonvulsants / administration & dosage*
  • Anticonvulsants / therapeutic use
  • Child
  • Encephalitis / complications
  • Encephalitis / diagnosis
  • Encephalitis / therapy*
  • Epilepsia Partialis Continua / complications
  • Epilepsia Partialis Continua / drug therapy
  • Female
  • Humans
  • Immunoglobulins / administration & dosage*
  • Immunoglobulins / therapeutic use
  • Magnetic Resonance Imaging

Substances

  • Anticonvulsants
  • Immunoglobulins