Epilepsia partialis continua and unilateral cortical-subcortical FLAIR-hyperintense lesion in Rasmussen's...

Area of Science:

• Neurology
• Neuroradiology
• Pediatric Neurology

Background:

• Rasmussen encephalitis (RE) is a rare, inflammatory neurological disorder.
• It is characterized by progressive unilateral brain damage, seizures, and motor deficits.
• The relationship between neuroimaging findings and epilepsia partialis continua (EPC) in RE is not well-defined.

Purpose of the Study:

• To investigate the association between MRI characteristics and the presence or progression of EPC in patients with RE.
• To correlate specific imaging patterns with clinical manifestations of EPC.

Main Methods:

• Retrospective analysis of 11 patients diagnosed with RE between 2015 and 2020.
• Review of initial and follow-up MRI scans in relation to seizure onset and EPC type.
• Correlation of imaging findings (cortical atrophy, hyperintensity) with clinical data.

Main Results:

• The mean age of seizure onset was 12 years.
• Limb EPC was most common (7 patients), followed by facial EPC (2 patients).
• Initial MRIs revealed cortical atrophy or hyperintensity in most patients; follow-up MRIs showed paramedian frontal or insular hyperintensity correlating with EPC.

Conclusions:

• FLAIR hyperintensity and focal cortical atrophy are common early MRI findings in RE.
• T2 and FLAIR hyperintensity in the paramedian frontal or insular cortex can precede or occur concurrently with EPC.
• Neuroimaging plays a crucial role in understanding the evolution of RE and its clinical manifestations.