Functional Hemispherotomy in a Patient with Rasmussen’s Encephalitis: A Case Report

Abstract

Background: Rasmussen’s encephalitis is a progressive disease with recurrent drug resistant epilepsy, unihemispheric brain atrophy, hemiplegia and cognitive decline. Objectives: This is a disconnection surgery which disconnects the diseased lobe from the normal lobe. This helps in development of the normal cerebral hemisphere and also the child becomes seizure free. Methods: A five year old boy was diagnosed with Rasmussen’s encephalitis. He underwent left sided transsylvian functional hemisherectomy. He had uneventful recovery. Results: Before surgery he had recurrent seizures, frequent drop attacks and right sided hemiplegia and impaired cognition. He used to take three drugs for the control of the seizure. After surgery his mental state had improved, seizures were controlled with only sodium valproate. Patient’s mother was happy that he had no drop attacks and was able to sit and speak. Conclusion: Functional hemispherectomy is a good option for drug resistant seizure in Ramussen’s encephalitis.