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Rasmussen's chronic encephalitis in adults

R S McLachlan¹, J P Girvin, W T Blume

¹Department of Clinical Neurological Sciences, University of Western Ontario, London.

Archives of Neurology

|March 1, 1993

Summary

Rasmussen's encephalitis, a rare neurological condition, affects adults causing intractable epilepsy and progressive deficits. Cytomegalovirus may play a role in its development.

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Area of Science:

Neurology
Pediatric Neurology
Neuroimmunology

Background:

Rasmussen's encephalitis is a rare, autoimmune neurological disease typically affecting children, characterized by chronic inflammation of one cerebral hemisphere.
It leads to intractable epilepsy, progressive hemiparesis, and cognitive decline.

Observation:

This study describes three adult cases of Rasmussen's encephalitis, presenting with intractable seizures, sensorimotor deficits, and cognitive decline.
Adult patients exhibited more bilateral hemispheric involvement and greater sensorimotor deficits compared to pediatric cases.
Cytomegalovirus (CMV) genome was detected in the resected cortical tissue of all three adult patients.

Findings:

Clinical, EEG, and MRI findings revealed patchy, multifocal brain involvement, predominantly in one hemisphere but with contralateral involvement in adults.
Surgical resection outcomes correlated with the extent of tissue removed, indicating its potential efficacy in seizure control.
The presence of CMV genome suggests a potential role for this virus in the pathogenesis of Rasmussen's encephalitis in adults.

Implications:

Rasmussen's encephalitis should be considered in the differential diagnosis of intractable epilepsy and progressive neurological deficits in adults.
The findings suggest that CMV infection may be a contributing factor to the development or progression of Rasmussen's encephalitis.
Further research into the role of viral infections, like CMV, in autoimmune encephalitis is warranted for improved understanding and treatment strategies.

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