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

Area of Science:

• Neurology
• Immunology

Background:

• Rasmussen encephalitis (RE) is a chronic inflammatory brain condition causing progressive neurological decline and severe seizures.
• Hemispherectomy is the primary treatment, but immunotherapy may slow tissue loss.

Observation:

• A girl presented with epilepsia partialis continua (EPC) and neurological dysfunction suggestive of RE.
• Initial MRI findings were misdiagnosed as focal cortical dysplasia.

Findings:

• Combined antiepileptic and immunomodulation therapy was administered for two years, showing initial benefits.
• Follow-up MRI revealed right parietal atrophy four years later.

Implications:

• This therapeutic combination may target RE's underlying mechanisms, mitigating neuronal damage.
• Such treatment could offer a way to slow the progression of Rasmussen encephalitis and preserve function.