Neurophysiology Service, National Institute of Neurology, Mexico.
Epilepsy Behav. 2011 Jan;20(1):126-31. doi: 10.1016/j.yebeh.2010.10.031. Epub 2010 Dec 17.
Rasmussen's encephalitis is a rare, progressive inflammatory disease that typically affects one cerebral hemisphere and causes intractable partial-onset seizures. Currently, the only effective therapy is hemispherectomy; however, this procedure is associated with irreversible neurological deficits. Novel therapeutic approaches to this condition are therefore necessary. One possible option that has not yet been extensively studied is electrical cathodal transcranial direct current stimulation (cTDCS). We describe the cases of two patients with atypical-onset Rasmussen's encephalitis who underwent cTDCS at 1- and 2-mA intensity for 60 minutes in four sessions (on days 0, 7, 30, and 60). No complications were recorded during their therapy. At follow-up evaluations 6 and 12 months later, one patient had a significant reduction in seizure frequency and one was seizure free. Additionally, both patients had improved levels of alertness and language. This is the first time that cTDCS has been applied in serial sessions to treat Rasmussen's encephalitis to avoid or delay surgical treatment.
拉森姆脑炎是一种罕见的、进行性的炎症性疾病，通常影响一侧大脑半球，并导致难治性部分发作性癫痫。目前，唯一有效的治疗方法是半球切除术；然而，该手术会导致不可逆转的神经功能缺损。因此，需要探索治疗这种疾病的新方法。一种尚未广泛研究的可能选择是电阴极经颅直流电刺激（cTDCS）。我们描述了两例发作不典型的拉森姆脑炎患者，他们分别以 1mA 和 2mA 的强度接受了 60 分钟的 cTDCS 治疗，共进行了 4 个疗程（在第 0、7、30 和 60 天）。在治疗过程中未记录到任何并发症。在 6 个月和 12 个月的随访评估中，一名患者的癫痫发作频率显著降低，另一名患者无癫痫发作。此外，两名患者的警觉性和语言能力均有所提高。这是首次应用连续 cTDCS 治疗拉森姆脑炎以避免或延迟手术治疗。
