Cerrahpaşa Faculty of Medicine, Department of Neurology, Istanbul University-Cerrahpaşa, Istanbul, Turkey.
Department of Neurology, Prof. Dr. Cemil Taşcıoğlu City Hospital, Istanbul, Turkey.
J Neurol. 2024 Feb;271(2):723-726. doi: 10.1007/s00415-023-12072-8. Epub 2023 Nov 3.
Rasmussen's encephalitis (RE) is a rare chronic neurological disorder, characterized by unilateral inflammation of the cerebral cortex, refractory focal epilepsy or epilepsia partialis continua, hemiparesis, and progressive cognitive decline. Interleukin-1 (IL-1) plays an important role in neuroinflammation as a key element in the activation of the inflammatory IL-1β-IL-1 receptor type 1 (IL-1R1) axis. Anakinra, an IL-1 inhibitor, is successfully used in patients with new onset refractory status epilepticus and febrile infection-related epilepsy syndrome.
We present 38-year-old male with RE having right-sided hemiparesis and continuous spasms being unresponsive to immune modulatory therapies like pulse steroid, intravenous immunoglobulin and anti-seizure drugs. After treatment with anakinra for three weeks, the continuous spasms almost completely subsided, and his muscle strength returned to normal.
Anakinra may be considered as a treatment option in patients with RE and refractory seizures.
拉森姆脑炎(RE)是一种罕见的慢性神经系统疾病,其特征为单侧大脑皮质炎症、难治性局灶性癫痫或部分连续性癫痫、偏瘫和进行性认知衰退。白细胞介素-1(IL-1)作为炎症反应中 IL-1β-IL-1 受体 1 型(IL-1R1)轴激活的关键因素,在神经炎症中发挥着重要作用。白细胞介素-1 抑制剂阿那白滞素已成功用于新发难治性癫痫持续状态和发热感染相关癫痫综合征患者。
我们报告了一例 38 岁男性患者,患有 RE,表现为右侧偏瘫和持续性痉挛,对免疫调节治疗如脉冲类固醇、静脉注射免疫球蛋白和抗癫痫药物无反应。阿那白滞素治疗 3 周后,持续性痉挛几乎完全缓解,肌力恢复正常。
对于 RE 合并难治性癫痫的患者,阿那白滞素可作为一种治疗选择。