Alfonso Maria A, Piñeros-Fernández Martha C, Jaimes Luisa F, Ramos Nicolas I
Pediatrics, Los Cobos Medical Center, Bogotá, COL.
Pediatric Neurology, Los Cobos Medical Center, Bogotá, COL.
Cureus. 2023 Oct 7;15(10):e46647. doi: 10.7759/cureus.46647. eCollection 2023 Oct.
A three-year-old female patient was admitted to our institution due to subacute fever, intermittent vomiting, persistent bilateral mydriasis after cycloplegia, right central facial palsy, and mild right hemiparesis with hyperreflexia. Brain MRI shows encephalitis in frontal, parietal, insular, and left putamen course and loss of cortical volume and white matter of the entire left hemisphere which are features described in Rasmussen's encephalitis (RE). Therapy with intravenous methylprednisolone bolus was initiated, with adequate clinical response. We consider in this case the diagnosis of atypical RE by imaging criteria in the subacute stage. There are few reports of atypical RE without epilepsy or continuous partial epilepsy. Our purpose is to present a case of a patient with RE images without epilepsy seizures and review the diagnostic and therapeutic approach of RE.
一名三岁女性患者因亚急性发热、间歇性呕吐、睫状肌麻痹后持续性双侧瞳孔散大、右侧中枢性面瘫以及伴有反射亢进的轻度右侧偏瘫入住我院。脑部磁共振成像显示额叶、顶叶、岛叶及左侧壳核部位存在脑炎，且整个左半球皮质体积和白质减少，这些都是拉斯穆森脑炎（RE）所描述的特征。开始采用静脉注射甲泼尼龙冲击治疗，临床反应良好。我们根据亚急性期的影像学标准考虑该病例为非典型RE。关于无癫痫或持续性部分性癫痫的非典型RE报道较少。我们的目的是呈现一例无癫痫发作的RE影像患者病例，并回顾RE的诊断和治疗方法。
