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Immunotherapy is a treatment that boosts or manipulates the immune system to fight diseases, including cancer. For instance, by stimulating an immune response through vaccinations against viruses that cause cancers, like hepatitis B virus and human papillomavirus, these diseases can be prevented. Nonetheless, some cancer cells can avoid the immune system due to their rapid mutation and division. The immune response to many cancers involves three phases: elimination, equilibrium, and escape.
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Chronic T Cell Encephalitis Responsive to Immunotherapy.

Arunmozhimaran Elavarasi1, Garima Shukla2, Deepti Vibha1

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Summary
This summary is machine-generated.

This case study highlights an atypical presentation of Rasmussen's encephalitis in an adult, featuring bilateral symptoms and unique neurological deficits. The findings challenge typical diagnostic criteria for this rare epilepsy syndrome.

Keywords:
Chronic T cell encephalitisRasmussen encephalitisepilepsia partialis continua

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Area of Science:

  • Neurology
  • Neuroimmunology

Background:

  • Rasmussen's encephalitis is a rare chronic inflammatory neurological disease causing progressive unilateral brain atrophy, typically in children.
  • It often presents with intractable focal epilepsy, hemiparesis, and cognitive decline.

Observation:

  • An adult patient presented with pseudobulbar affect and frontal lobe dysfunction.
  • The patient developed multifocal myoclonic jerks, focal motor seizures, and hemiparesis with bilateral cerebellar signs.
  • Imaging revealed progressive hemispheric atrophy with bilateral involvement.

Findings:

  • Brain biopsy confirmed chronic T-cell infiltrate, consistent with inflammation.
  • The patient's presentation included atypical features such as bilateral symptoms and specific neurological deficits not typically seen in Rasmussen's encephalitis.
  • Positron emission tomography-computed tomography (PET CT) demonstrated bilateral features.

Implications:

  • This case expands the understanding of the clinical spectrum of Rasmussen's encephalitis, particularly in adult-onset and bilateral presentations.
  • It underscores the importance of considering atypical presentations and utilizing advanced imaging and biopsy for diagnosis.
  • Further research is needed to elucidate the pathogenesis and optimize treatment strategies for such complex cases.