Rasmussen encephalitis: Case report

Abstract

The purpose of this report is to inform the internal medicine community of a case of epilepsy secondary to treatable chronic focal encephalitis and to discuss its possible variants in adults. The patient was evaluated clinically, with MRI images and video EEG. A 12-year-old patient who from the age of 3 presented symptoms of parasomnia suggestive of sleepwalking followed by left generalized secondary motor focal seizures with left brachiocrural paresis, a progressive condition that began with one crisis per week until reaching more than 1000/month, refractory to medical treatment. The MRI showed right temporal-frontal and insular atrophy, and the EEG video showed multifocal epileptiform foci in the right hemisphere, predominantly center frontal, correlated with secondary generalized focal motor seizures in the left hemisphere. The cerebrospinal fluid was normal, a patient who meets three criteria for Rasmussen's encephalitis is presented, it is the first case reported in El Salvador.