[P3-187] The Dilemma In Managing Rasmussen’s Encephalitis
A 10 years old girl who presented to our pediatric neurology clinic with history of focal tonic-clonic seizures of the left side and deterioration of school performance in the last 6 months . Epilepsia Partialis Continua noted in the clinic with left sided weakness. EEG showed asymmetry of the background, a slower right hemisphere, spikes and sharp waves in the right hemisphere with ictal seizures in the right fronto-tempro-centro-parietal head regions. MRI brain showed right hippocampus atrophy with increase flair signal intensity of adjacent temporal horn. PET scan brain showed global reduced metabolic activity of the right cerebral hemisphere and partially right thalamus. Neuropsychology evaluation showed borderline cognitive function with difficulty in paying attention and impulsivity. Patient went through comprehensive workup to rule out other conditions which might cause intractable epilepsy and cognitive deterioration like autoimmune diseases and vasculitis. Brain biopsy was suggestive of Rasmussen encephalitis. So, patient underwent right functional hemispherectomy ,after the surgery she became seizure free with improvement in cognitive function and reduction in inattention and impulsivity.