Rasmussen encephalitis in childhood

Six patients admitted to the Department of Pediatric Neurology at Hacettepe University Children's Hospital between 1992 and 1997 with a clinical diagn osis of Rasmussen encephalitis received surgical treatment for their intrac table epilepsy. MRI, SPECT and WADA tests were performed in patients with a n epileptic focus demonstrated on routine or long-term video EEG monitoring . Viral studies using the PCR methodology were performed in cases with hist opathological evidence of Rasmussen encephalitis. The ages of these patient s ranged between 7 and 16 years, and the mean age at onset of seizures was 7.1+/-2.2 years. In four patients seizures presented as epilepsia partialis continua and were refractory to anticonvulsive drug therapy. In three case s intravenous immunoglobulin therapy yielded temporary and partial improvem ent in seizure control. The mean presurgical follow-up duration was 2.04+/- 1.74 years, and early surgical intervention for epilepsy was performed in o ne case. The surgical approach selected for the treat ment of epilepsy was resective surgery with electrocorticography. The mean postoperative follow- up duration was 32.3+17.2 months. Seizures were fully controlled in one pat ient, in whom surgery was performed 3 months after the seizures first start ed. Early surgical intervention may provide histopathological evidence for diagnosis as well as effective seizure control.