[Three children with Rasmussen encephalitis showing marked improvement in daily life activity following the functional hemispherectomy].

Abstract

We investigated seizure, intelligence quotient (IQ), and neurological outcomes including the process of motor function recovery after functional right hemispherectomy in 3 children with Rasmussen's encephalitis (RE). Before the procedure, they were unable to walk, nor sit without support due to progressive worsening of left hemiplegia and relentless epilepsia partialis continua (EPC) of the left extremities, which were refractory to antiepileptic drug and immunological treatment. After functional right hemispherectomy, EPC completely disappeared, although complete left hemiplegia was sustained. However, they recovered up to being able to walk independently with assistance devices, and to have an ordinary life with family support within 1.5 to 5 months through rehabilitation. At the same time, the interictal EEG improved on the unaffected side of hemisphere, exhibiting a posterior alpha rhythm. Their IQ also improved, and they were able to attend school. Early functional hemispherectomy should be considered before patients with RE are left in a serious condition due to progressive worsening of hemiplegia and seizures refractory to the available treatment.

• Authors: Mutsuki Shioda, Hirokazu Oguni, Yasushi Ito, Taku Ochiai, Tomokatsu Hori, Ayako Muto, Satornu Takahashi, Akie Miyamoto, Hitoshi Osaka, Makiko Osawa
• Journal: No to hattatsu = Brain and development (No To Hattatsu) Vol. 43 Issue 5 Pg. 373-7 (Sep 2011) ISSN: 0029-0831 [Print] Japan
• PMID: 21941844 (Publication Type: Case Reports, English Abstract, Journal Article)

Topics

• Activities of Daily Living
• Adolescent
• Child
• Electroencephalography
• Encephalitis (physiopathology, psychology, rehabilitation, surgery)
• Female
• Hemispherectomy
• Humans
• Intelligence
• Treatment Outcome