EPILEPSIA PARTIALIS CONTINUO DUE TO RASMU SSENS ENCEPHALITIS - A CASE-REPORT

After a highly febrile episode lasting for 4 weeks in 1990, a ten-year old boy developed focal sensorimotor seizures of the left hand, initi ally with secondary generalisation. Despite antiepileptic therapy epil epsia partialis continua (EPC) persisted involving the left arm. EEC s howed an epileptic focus, CT was normal at that time. A progressive sp astic hemiparesis of the left side developed. 7 years later right-side d hemiatrophia cerebri and contralateral cerebellar atrophy were revea led by MRI/MRSI corresponding with low perfusion on Tc-99m-HMPAO-SPECT , which showed 3 regions (anterior-temporal, frontal and parietal righ t) with relative hyperperfusion probably correlated to epileptic foci. History, clinical course, perfusion study, MRI and EEG findings are c onsistent with Rasmussen's encephalitis. A virus infection is assumed but the etiology of this childhood disease is not known. Recent data s upport autoimmunological aspects triggering EPC by GluR3 antibodies. P ersisting seizures are best treated with functional hemispherectomy.