PEDIATRIC RASMUSSEN ENCEPHALITIS - SOCIAL COMMUNICATION, LANGUAGE, PET, AND PATHOLOGY BEFORE AND AFTER HEMISPHERECTOMY

This prospective case study examined social communication (i.e., forma l thought disorder, cohesion), language, positron emission tomography glucose utilization, and neuropathology in four children with Rasmusse n encephalitis who achieved seizure control following right hemisphere ctomy. Prior to hemispherectomy, all four children had illogical think ing, loose associations, cohesive deficits, and impaired performance o n formal language tests. Their postoperative improvement in social com munication and language appeared to be related to age of onset, durati on of illness, and postsurgical reversibility of hypometabolism in the nonresected prefrontal cortex. These changes were not associated with increase in IQ scores. The variability in the type and extent of path ologic change across subjects reflected the severity and duration of t he illness. The study's findings imply that early surgical interventio n might have mitigated certain aspects of the social communication and linguistic deficits found in these children. (C) 1996 Academic Press, Inc.