Rasmussen’s Encephalitis

Authors: G. Timárová 1;  I. Lisá 1;  P. Mikula 2;  M. Šimko In Memoriam 3
Authors‘ workplace: II. Neurologická klinika LF UK a UN Bratislava 1;  Rádiologická klinika LF UK, SZU a UN Bratislava 2;  I. interná klinika Dionýza Diešku, LF SZU a UN Bratislava 3
Published in: Cesk Slov Neurol N 2016; 79/112(5): 500-512
Category: Minimonography
doi: 10.14735/amcsnn2016500


Rasmussen’s encephalitis is a rare chronic neurologic disease characterized by three main features: refractory epilepsy, progressive unihemispheric atrophy of the brain and progressive neurological deficit. This chronic focal encephalitis typically affects children but adolescents and adults are also involved. Neuropathological and immunological studies indicate that Rasmussen’s encephalitis is probably driven by a T-cell cytotoxic response with potential additional contribution by autoantibodies and activated microglia. Primary cause of the disease remains unsolved. MRI may be a good biomarker in Rasmussen’s encephalitis but we do not have relevant serological markers yet. Immunomodulatory treatments seem to slow disease progressiaon in Rasmussen’s encephalitis but long-term outcomes remain unclear. Functional hemispherectomy remains the only effective treatment for seizures but there are inevitable functional compromises associated with it. The decision and timing of surgery may be problematic in the absence of a dense neurological deficit, and if the patient is older. For patients, their families and treating physicians, choosing the right time to move from medical management to surgery is a real therapeutic dilemma. Due to poor prognosis, patients with susspected Rasmussen’s encephalitis should immediately be referred to an epilepsy centre.

Key words:
chronic encephalitis – refractory epilepsy – diagnostics – immunomodulatory therapy – hemispherectomy

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manuscript met the ICMJE “uniform requirements” for biomedical papers.


1. Rasmussen T, Olszewski J, Loyd-Smith D. Focal seizures due to chronic localized encephalitis. Neurology 1958; 8 (6): 435–45.

2. Sheybani L, Schaller K, Seeck M. Rasmussen’s encephalitis: an update. Schweizer Archiv Neurol Psych 2011; 162 (6): 225–31.

3. Krýsl D, Elišák M. Autoimunitní encefalitidy. Cesk Slov Neurol N 2015; 78/111 (1): 7–23. doi: 10.14735/amcsnn20157.

4. Mastrangelo M, Mariani R, Menichella A. Eponym Rasmussen syndrome. Eur J Pediatr 2010; 169 (8): 919–24. doi: 10.1007/s00431-010-1148-0.

5. Oguni H, Andermann F, Rasmussen TB. The syndrome of Chronic Encephalitis and Epilepsy. Adv Neurol 1992; 57: 419–33.

6. Oguni H, Andermann F, Rasmussen TB. The natural history of the syndrome of chronic encephalitis and epilepsy: a study of the MNI series of forty-eight cases. In: Andermann F, ed. Chronic encephalitis and epilepsy – Rasmussen’s syndrome. Boston: Butterworth-Heinemann 1991: 7–35.

7. Bien CG, Widman G, Urbach H, et al. The natural history of Rasmussen’s encephalitis. Brain 2002; 125 (8): 1751–9. doi: org/10.1093/brain/awf176.

8. Gray F, Serdaru M, Baron H, et al. Chronic localised encephalitis (Rasmussen’s) in an adult with epilepsia partialis continua. J Neurol Neurosurg Psychiatry 1987; 50 (6): 747–75.

9. Hart YM, Andermann F, Fish DR, et al. Chronic encephalitis and epilepsy in adults and adolescents: a variant of Rasmussen’s syndrome? Neurology 1997; 48 (2): 418–24.

10. Villani F, Pincherle A, Antozzi C, et al. Adult-onset Rasmussen’s encephalitis: anatomical-electrographic-clinical features of 7 Italian cases. Epilepsia 2006; 47 (5): 41–6. doi: 10.1111/j.1528-1167.2006.00876.x.

11. Bien CG, Tiemeier H, Sassen R, et al. Rasmussen encephalitis: incidence and course under randomized therapy with tacrolimus or intravenous immunoglobulins. Epilepsia 2013; 54 (3): 543–50. doi: 10.1111/epi.12042.

12. Lamb K, Scott WJ, Mensah A, et al. Prevalence and clinical outcome of Rasmussen encephalitis in children from the United Kingdom. Dev Med Child Neurol 2013; 55 (Suppl 1): 14.

13. Varadkar S, Bien CG, Kruse CA, et al. Rasmussen’s encephalitis: clinical features, pathobiology, and treatment advances. Lancet Neurol 2014; 13 (2): 195–205. doi: 10.1016/S1474-4422 (13) 70260-6.

14. Thomas JE, Reagan TJ, Klass DW. Epilepsia partialis continua. A review of 32 cases. Arch Neurol 1977; 34 (5): 266–75.

15. Obeso JA, Rothwell JC, Marsden CD. The spectrum of cortical myoclonus. From focal reflex jerks to spontaneous motor epilepsy. Brain 1985; 108 (1): 193–224.

16. Longaretti F, Dunkley C, Varadkar S, et al. Evolution of the EEG in children with Rasmussen’s syndrome. Epilepsia 2012; 53 (9): 1539–45. doi: 10.1111/j.1528-1167.2012.03565.x.

17. Bien CG, Granata T, Antozzi C, et al. Pathogenesis, diag- nosis and treatment of Rasmussen encephalitis: a European consensus statement. Brain 2005; 128 (3): 454–71. doi: org/10.1093/brain/awh415.

18. Bauer J, Bien CG. Encephalitis and epilepsy. Semin Immunopathol 2009; 31 (4): 537–44. doi: 10.1007/s00281-009-0176-1.

19. Cheong JY, Wong C, Bleasel A, et al. Late onset Rasmussen’s encephalitis with tripple pathology. J Clin Neurosci 2009; 16 (12): 1677–81. doi: 10.1016/j.jocn.2009.02.042.

20. Gambardella A, Andermann F, Shorvon S, et al. Limited chronic focal encephalitis: another variant of Rasmussen syndrome? Neurology 2008; 70 (Suppl 6): 13–8. doi: 10.1111/j.1528-1167.2008.01751.x.

21. McLachlan RS, Girvin JP, Blume WT, et al. Rasmussen’s chronic encephalitis in adults. Arch Neurol 1993; 50 (3): 269–74.

22. Hart YM, Andermann F, Robitaille Y, et al. Double pathology in Rasmussen’s syndrome: a window on the etiology? Neurology 1998; 50 (3): 731–5.

23. Hennessy MJ, Koutroumanidis M, Dean AF, et al. Chronic encephalitis and temporal lobe epilepsy: a variant of Rasmussen’s syndrome? Neurology 2001; 56 (5): 678–81.

24. Kashihara K, Ohno M, Takahashi Y. Twenty-one-year course of adult onset Rasmussen’s encephalitis and bilateral uveitis: case report. J Neurol Sci 2010; 294 (1–2): 127–30. doi: 10.1016/j.jns.2012.10.021.

25. Larionov S, Konig R, Urbach H, et al. MRI brain volumetry in Rasmussen encephalitis: the fate of affected and „unaffected“ hemispheres. Neurology 2005; 64 (5): 885–7.

26. Tobias SM, Robitaille Y, Hickey WF, et al. Bilateral Rasmussen encephalitis: postmortem documentation in a five-year-old. Epilepsia 2003; 44 (1): 127–30.

27. Chinchilla D, Dulac O, Robain O, et al. Reappraisal of Rasmussen’s syndrome with special emphasis on treatment with high doses of steroids. J Neurol Neurosurg Psychiatry 1994; 57 (11): 1325–33.

28. Peariso K, Standridge SM, Hallinan BE, et al. Presentation, diagnosis and treatment of bilateral Rasmussen’s encephalitis in a 12-year-old female. Epileptic Disord 2013; 15 (3): 324–32. doi: 10.1684/epd.2013.0594.

29. Bhatjiwale MG, Polkey C, Cox TC, et al. Rasmussen’s encephalitis: neuroimaging findings in 21 patients with a closer look at the basal ganglia. Pediatr Neurosurg 1998; 29 (3): 142–8.

30. Ben-Zeev B, Nass D, Polack S, et al. Progressive unilateral basal ganglia atrophy and hemidystonia: new form of chronic focal viral encephalitis. Neurology 1999; 51 (Suppl 1): 42.

31. de Leva MF, Varrone A, Filla A, et al. Neuroimaging follow-up in a Case of Rasmussen’s Encephalitis with Dyskinesias. Mov Disord 2007; 22 (14): 2117–21. doi: 10.1016/j.pediatrneurol.2008.03.001.

32. Frucht S. Dystonia, athetosis, and epilepsia partialis continua in a patient with late-onset Rasmussen’s encephalitis. Mov Disord 2002; 17 (3): 609–12.

33. Koen MA, Zupanc ML. Unusual presentation and MRI findings in Rasmussen’s syndrome. Pediatr Neurol 1999; 21 (5): 839–42.

34. McDonald D, Farrell MA, McMenamin J. Rasmussen’s syndrome associated with chronic brain stem encephalitis. Eur J Paediatr Neurol 2001; 5 (5): 203–6.

35. Bien CG, Elger CE, Leitner Y, et al. Slowly progressive hemiparesis in childhood as a consequence of Rasmussen encephalitis without or with delayed-onset seizures. Eur J Neurol 2007; 14 (4): 387–90.

36. Korn-Lubetzki I, Bien CG, Bauer J, et al. Rasmussen encephalitis with active inflammation and delayed seizures onset. Neurology 2004; 62 (6): 984–6.

37. Bien CG, Urbach H, Deckert M, et al. Diagnosis and staging of Rasmussen’s encephalitis by serial MRI and histopathology. Neurology 2002; 58 (2): 250–7.

38. Chiapparini L, Granata T, Farina L, et al. Diagnostic imaging in 13 cases of Rasmussen’s encephalitis: can early MRI suggest the diagnosis? Neuroradiology 2003; 45 (3): 171–83.

39. Wagner J, Schoene-Bake JC, Bien CG, et al. Automated 3D MRI volumetry reveals regional atrophy differences in Rasmussen encephalitis. Epilepsia 2012; 53 (4): 613–21. doi: 10.1111/j.1528-1167.2011.03396.x.

40. Bien CG, Elger CE, Wiendl H. Advances in pathogenic concepts and therapeutic agents in Rasmussen’s encephalitis. Expert Opin Investig Drugs 2002; 11 (2): 981–9.

41. Geller E, Faerber EN, Legido A, et al. Rasmussen encephalitis: complementary role of multitechnique neuroimaging. Am J Neuroradiol 1998; 19 (4): 445–9.

42. Sener RN. Diffusion MRI and spectroscopy in Rasmussen’s encephalitis. Eur Radiol 2003; 13 (9): 2186–91.

43. Cendes F, Andermann F, Silver K. Imaging of axonal damage in vivo in Rasmussen’s syndrome. Brain 1995; 118 (3): 753–8.

44. Sener RN. Rasmussen’s encephalitis: proton MR spectroscopy and diffusion MR findings. J Neuroradiol 2000; 27 (3): 179–84.

45. Fiorella DJ, Provenzale JM, Edward CR,et al. 18F-fluorodeoxyglucose positron emission tomography and MR imaging findings in Rasmussen encephalitis. Am J Neuroradiol 2001; 22 (7): 1291–9.

46. Lee JS, Juhasz C, Kaddurah AK, et al. Patterns of cerebral glucose metabolism in early and late stages od Rasmussen’s syndrome. J Child Neurol 2001; 16 (11): 798–805.

47. Maeda Y, Oguni H, Sato Y, et al. Rasmussen syndrome: multifocal spread of inflammation suggested from MRI and PET findings. Epilepsia 2003; 44 (8): 1118–21.

48. Shah JR, Juhasz C, Kupsky WJ, et al. Rasmussen encephalitis associated with Parry-Romberg syndrome. Neurology 2003; 61 (3): 395–7.

49. Burke GJ, Fifer SA, Yoder J. Early detection of Rasmussen’s syndrome by brain SPECT imaging. Clin Nucl Med 1992; 17 (9): 730–1.

50. Hartley LM, Gordon I, Harkness W, et al. Correlation of SPECT with pathology and seizure outcome in children undergoing epilepsy surgery. Dev Med Child Neurol 2002; 44 (10): 676–80.

51. Rasmussen T, Andermann F. Update on the syndrome of chronic encephalitis and epilepsy. Cleveland Clin J Med 1989; 56 (Suppl 2): 181–4.

52. Granata T, Gobbi G, Spreafico R, et al. Rasmussen’s encephalitis: early characteristics allow diagnosis. Neurology 2003; 60 (3): 422–5.

53. Robitaille Y. Neuropathologic aspects of chronic encephalitis. In: Andermann F, ed. Chronic encephalitis and epilepsy. Rasmussen’s syndrome. Boston: Butterworth- Heinemann 1991: 79–110.

54. Farrell MA, Droogan O, Secor DL, et al. Chronic encephalitis associated with epilepsy: immunohistochemical and ultrasturctural studies. Acta Neuropathol Berl 1995; 89 (4): 313–21.

55. Pardo CA, Vining EP, Guo L, et al. The pthology of Rasmussen syndrome: stages of cortical involvement and neuropathological sudies in 45 hemispherectomies. Epilepsia 2004; 45 (5): 516–26.

56. Booss J, Esiri MM. Viral encephalitis in humans. Washington DC: ASM Press 2003.

57. Graus F, Ribalta T, Campo E, et al. Immunohisto-chemical analysis of the immune reaction in the nervous system in paraneoplastic encephalomyelitis. Neurology 1990; 40 (2): 219–22.

58. Bien CG, Schulze-Bonhage A, Deckert M, et al. Limbic encephalitis not associated with neoplasm as a cause of temporal lobe epilepsy. Neurology 2000; 55 (12): 1823–8.

59. Bien CG, Bauer J, Deckwerth TL, et al. Destruction of neurons by cytotoxic T cells: a new pathogenetic mechanism in Rasmussen’s encephalitis. Ann Neurol 2002; 51 (3): 311–8.

60. Wang Y, Qin ZH. Molecular and cellular mechanisms of excitotoxic neuronal death. Apoptosi 2010; 15 (11): 1382–402. doi: 10.1007/s10495-010-0481-0.

61. Takei H, Wilfong A, Malphrus A, et al. Dual pathology in Rasmussen’s encephalitis: a study of seven cases and review of the literature. Neuropathology 2010; 30 (4): 381–91. doi: 10.1111/j.1440-1789.2009.01079.x.

62. Iyer A, Zurolo E, Spliet WG, et al. Evaluation of the innate and adaptive immunity in type I and type II focal cortical dysplasias. Epilepsia 2010; 51 (9): 1763–73. doi: 10.1111/j.1528-1167.2010.02547.x.

63. Friedman H, CH’ien L, Parham D. Virus in brain of child with hemiplegia, hemiconvulsions, and epilepsy. Lancet 1977; 2 (8039): 666.

64. Walter GF, Renella RR. Epstein-Barr virus in brain and Rasmussen’s encephalitis. Lancet 1989; 1 (8632): 279–80.

65. Power C, Poland SD, Blume WT, et al. Cytomegalovirus and Rasmussen’s encephalitis. Lancet 1990; 336 (8726): 1282–4.

66. Farrell MA, Cheng L, Cornford ME, et al. Cytomegalovirus and Rasmussen’s encephalitis. Lancet 1991; 337 (8756): 1551–2.

67. Vinters HV, Wang R, Wiley CA. Herpesviruses in chronic encephalitis associated with intractable childhood epilepsy. Hum Pathol 1993; 24 (8): 871–9.

68. McLachlan RS, Levin S, Blume WT. Treatment of Rasmussen’s syndrome with ganciclovir. Neurology 1996; 47 (4): 925–8.

69. Jay V, Becker LE, Otsubo H, et al. Chronic encephalitis and epilepsy (Rasmussen’s encephalitis: detection of cytomegalovirus and herpes simplex virus 1 by the polymerase chain reaction and in situ hybridization. Neurology 1995; 45 (1): 108–17.

70. Atkins MR, Terrell W, Hulette CM. Rasmussen’s syndrome: a study of potential viral etiology. Clin Neuropathol 1995; 14 (1): 7–12.

71. Vincent A, Bien CG, Irani SR, et al. Autoantibodies associated with diseases of the CNS: new developments and future challenges. Lancet Neurol 2011; 10 (8): 759–72. doi: 10.1016/S1474-4422 (11) 70096-5.

72. Lancaster E, Dalmau J. Neuronal autoantigens – pathogenesis, associated disorders and antibody testing. Nat Rev Neurol 2012; 8 (7): 380–90. doi: 10.1038/nrneurol.2012.99.

73. Rogers SW, Andrews PI, Gahring LC, et al. Autoantibodies to glutamate receptor GluR3 in Rasmussen’s encephalitis. Science 1994; 265 (5172): 648–51.

74. Pleasure D. Diagnostic and Pathogenetic Significance of Glutamate Receptor Autoantibodies. Arch Neurol 2008; 65 (5): 589–92. doi: 10.1001/archneur.65.5.589.

75. Greiner H, Leach JL, Lee KH, et al. Anti-NMDA receptor encephalitis presenting with imaging findings and clinical features mimicking Rasmussen syndrome. Seizure 2011; 20 (3): 266–70. doi: 10.1016/j.seizure.2010.11.013.

76. Wiendl HM, Bien CG, Bernasconi PP, et al. GluR3 antibodies: prevalence in focal epilepsy but no specificity for Rasmussen’s encephalitis. Neurology 2001; 57 (8): 1511–14.

77. Mantegazza R, Bernasconi P, Baggi F, et al. Antibodies against GluR3 peptides are not specific for Rasmussen’s encephalitis but are also present in epilepsy patients with severe, early onset disease and intractable seizures. J Neuroimmunol 2002; 131 (1–2): 179–85.

78. Watson R, Jiang Y, Bermudez I, et al. Absence of antibodies to glutamate receptor type 3 (GluR3) in Rasmussen encephalitis. Neurology 2004; 63 (1): 43–50.

79. Yang R, Puranam RS, Butler LS, et al. Autoimmunity to munc-18 in Rasmussen’s encephalitis. Neuron 2000; 28 (2): 375–83.

80. Watson R, Jepson JE, Bermudez I, et al. Alpha7- acetylcholine receptor antibodies in two patients with Rasmussen encephalitis. Neurology 2005; 65 (11): 1802–4. doi: 10.1212/01.wnl.0000191566.86977.04.

81. Alvarez-Baron E, Bien CG, Schramm J, et al. Autoantibodies to Munc18, cerebral plasma cells and B-lymphocytes in Rasmussen encephalitis. Epilepsy Res 2008; 80 (1): 93–7. doi: 10.1016/j.eplepsyres.2008.03.007.

82. Owens GC, Huynh M, Chang JW, et al. Differential expression of Interferon-alfa and chemokines genes distinguishes Rasmussen encephalitis from cortical dysplasia and provides evidence for an early Th1 immune response. J Neuroinflammation 2013; 10: 56–69. doi: 10.1186/1742-2094-10-56.

83. Schwab N, Bien CG, Waschbisch A, et al. CD8+ T cell clones dominate brain infiltrates in Rasmussen encephalitis and persist in the periphery. Brain 2009; 132 (5): 1236–46. doi: 10.1093/brain/awp003.

84. Bauer J, Elger CE, Hans VH, et al. Astrocytes are a specific immunological target in Rasmussen’s encephalitis. Ann Neurol 2007; 62 (1): 67–80. doi: 10.1002/ana.21148.

85. Wirenfeldt M, Clare R, Tung S, et al. Increased activation of Iba1+ microglia in pediatric epilepsy patients with Rasmussen’s encephalitis compared with cortical dysplasia and tuberous sclerosis complex. Neurobiol Dis 2009; 34 (3): 432–40. doi: 10.1016/j.nbd.2009.02.015.

86. Balosso S, Maroso M, Sanchez-Alavez M, et al. A novel non-transcriptional pathway mediates the proconvulsive effects of interleukin-1beta. Brain 2008; 131 (12): 3256–65. doi: 10.1093/brain/awn271.

87. Schafer DP, Lehrman EK, Kautzman AG, et al. Microglia sculpt postnatal neural circuits in an activity and complement-dependent manner. Neuron 2012; 74 (4): 691–705. doi: 10.1016/j.neuron.2012.03.026.

88. Stephan AH, Barres BA, Stevens B. The complement system: an unexpected role in synaptic pruning during development and disease. Annu Rev Neurosci 2012; 35: 369–89. doi: 10.1146/annurev-neuro-061010-113810.

89. Ivens S, Kaufer D, Flores L, et al. TGF-b receptor-mediated albumin uptake into astrocytes is involved in neocortical epileptogenesis. Brain 2007; 130 (2): 535–47.

90. Takahashi Y, Mine J, Kubota Y, et al. A substantial number of Rasmussen syndrome patients have increased IgG, CD4+ T cells, TNFa, and Granzyme B in CSF. Epilepsia 2009; 50 (6): 1419–31. doi: 10.1111/j.1528-1167.2008.01977.x.

91. Ramaswarny V, Walsh JG, Sinclair DB, et al. Inflammasome induction in Rasmussen’s encephalitis: cortical and associated white matter pathogenesis. J Neuroinflammation 2013; 10: 152. doi: 10.1186/1742-2094-10-152.

92. Bien CG, Schramm J. Treatment of Rasmussen encephalitis half a century after its initial description: promising prospects and a dilemma. Epilepsy Res 2009; 86 (2): 101–12. doi: 10.1016/j.eplepsyres.2009.06.001.

93. Dubeau F, Sherwin AL. Pharmacologic principles in the management of chronic focal encephalitis. In: Ander- mann F, ed. Chronic encephalitis and epilepsy Rasmussen’s syndrome. Boston: Butterworth-Heinemann 1991: 179–92.

94. Lozsadi DA, Hart IK, Moore AP. Botulinum toxin A improves involuntary limb movements in Rasmussen syndrome. Neurology 2004; 62 (7): 1233–34.

95. Browner N, Azher SN, Jankovic J. Botulinum toxin treatment of facial myoclonus in suspected Rasmussen encephalitis. Mov Disord 2006; 21 (9): 1500–2.

96. Grujic J, Bien CG, Pollo C, et al. Vagus nerve stimulator treatment in adult-onset Rasmussen’s encephalitis. Epilepsy Behav 2011; 20 (1): 23–5. doi: 10.1016/j.yebeh.2010.10.024.

97. San-Juan D, Calcaneo JD, Gonzalez-Aragon MF, et al. Transcranial direct current stimulation in adolescent and adult Rasmussen’s encephalitis. Epilepsy Behav 2011; 20 (1): 126–31. doi: 10.1016/j.yebeh.2010.10.031.

98. Hart YM, Cortez M, Andermann F, et al. Medical treatment of Rasmussen’s syndrome (chronic encephalitis and epilepsy): effect of high-dose steroids or immunoglobulins in 19 patients. Neurology 1994; 44 (6): 1030–6.

99. Granata T, Fusco L, Gobbi G, et al. Experience with immunomodulatory treatments in Rasmussen’s encephalitis. Neurology 2003; 61 (12): 1807–10.

100. Leach JP, Chadwick DW, Miles JB, et al. Improvement in adult-onset Rasmussen’s encephalitis with long-term immunomodulatory therapy. Neurology 1999; 52 (4): 738–42.

101. Timarova G, Lisa I, Dudasova K, et al. Immunomodulation therapy in three cases of late-onset Rasmussen encephalitis. Abstract. AES Washington 2013. [online]. Available from URL: https://www.aesnet.org/meetings_events/annual_meeting_abstracts/find/Timarova/2/2/0.

102. Andrews PI, Dichter MA, Berkovic SF, et al. Plasmapheresis in Rasmussen’s encephalitis. Neurology 1996; 46 (1): 242–6.

103. Antozzi C, Granata T, Aurisano N, et al. Long-term selective IgG immuno-adsorption improves Rasmussen’s encephalitis. Neurology 1998; 51 (1): 302–5.

104. Bien CG, Gleissner U, Sassen R, et al. An open study of tacrolimus therapy in Rasmussen’s encephalitis. Neurology 2004; 62 (11): 2106–9.

105. Varadkar S, Chong WK, Robinson R, et al. Azathioprine therapy in Rasmussen Syndrome. Epilepsy Currents 2012; 12 (Suppl 1): 417.

106. McLachlan RS, Levin S, Blume WT. Treatment of Rasmussen’s syndrome with gancyclovir. Neurology 1996; 47 (4): 925–8.

107. Thilo B, Stingele R, Knudsen K, et al. A case of Rasmussen encephalitis treated with rituximab. Nat Rev Neurol 2009; 5 (8): 458–62. doi: 10.1038/nrneurol.2009.98.

108. Lockman J, Le S, Fisher RS, et al. Case Report: Rasmussen’s Encephalitis Treated Successfully with Rituximab. Cureus 2013; 5 (8): e136. doi: 10.7759/cureus.136.

109. Bittner S, Simon OJ, Gobel K, et al. Rasmussen encephalitis treated with natalizumab. Neurology 2013; 81 (4): 395–7. doi: 10.1212/WNL.0b013e31829c5ceb.

110. Vining E, Freeman J, Pillas D, et al. Why Would You Remove Half a Brain? The Outcome of 58 Children After Hemispherectomy – the Johns Hopkins Experience: 1968 to 1996. Pediatrics 1997; 100 (2): 163–71.

111. Kossoff EH, Vining EP, Pillas DJ, et al. Hemispherectomy for intractable unihemispheric epilepsy, etiology vs outcome. Neurology 2003; 61 (7): 887–90. doi: org.10.1212/01.

112. Jonas R, Nguyen S, Hu B, et al. Cerebral hemispherectomy: hospital course, seizure, developmental, language, and motor outcomes. Neurology 2004; 62 (10): 1712–21.

113. Pulsifer MB, Brandt J, Salorio CF, et al. The cognitive outcome of hemispherectomy in 71 children. Epilepsia 2004; 45 (4): 243–54. doi: 10.1111/j.1528-1167.2009.02335.x.

114. Villemure JG. Hemispherectomy: Techniques and Complications. In: Wyllie E, ed. The treatment of epilepsy and practices. Philadelphia: Lea and Febiger 1997: 1081–6.

115. Honavar M, Janota I, Polkey CE. Rasmussen’s encephalitis in surgery for epilepsy. Dev Med Child Neurol 1992; 34 (1): 3–14.

116. Thomas SG, Chacko AG, Thomas MM, et al. Outcomes of disconnective surgery in intractable pediatric hemispheric and subhemispheric epilepsy. Int J Pediatr 2012; 2012: 527891. doi: 10.1155/2012/527891.

117. Follett P, Vora N, Cross JH. Paediatric Intractable Epilepsy Syndromes: changing concepts in diagnosis and management. Adv Tech Stand Neurosurg 2012; 39: 45–60. doi: 10.1007/978-3-7091-1360-8_2.

118. Althausen A, Gleissner U, Hoppe C, et al. Long-term outcome of hemispheric surgery at different ages in 61 epilepsy patients. J Neurol Neurosurg Psychiatry 2013; 84 (5): 529–36. doi: 10.1136/jnnp-2012-303811.

119. Van Empelen R, Jennekens-Schinkel A, Buskens E, et al. Functional consequences of hemispherectomy. Brain 2004; 127 (9): 2071–9.

120. Boatman D, Freeman J, Vining E, et al. Language recovery after left hemispherectomy in children with late-onset seizures. Ann Neurol 1999; 46 (13): 579–86.

Paediatric neurology Neurosurgery Neurology

Article was published in

Czech and Slovak Neurology and Neurosurgery

Issue 5

2016 Issue 5

Most read in this issue

This topic is also in:

Forgotten password

Don‘t have an account?  Create new account

Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.


Don‘t have an account?  Create new account