TY - JOUR
T1 - Good outcome in adult-onset Rasmussen's encephalitis syndrome
T2 - Is recovery possible?
AU - Poloni, Tino Emanuele
AU - Galli, Alberto
AU - Pichiecchio, Anna
AU - Di Lodovico, Laura
AU - Ceroni, Mauro
PY - 2015/6/1
Y1 - 2015/6/1
N2 - A healthy 29-year-old man suffered from adult-onset epilepsy, characterized by polymorphic progressive seizures resistant to AEDs, leading to unilateral cortical deficits and atrophy of the left hemisphere. The disorder satisfied the clinical, EEG, and imaging criteria for a diagnosis of Rasmussen's encephalitis. During the acute phase of the disease, intrathecal synthesis of specific anti-CMV IgG was identified. This case was characterized by a very mild course and remission of seizures following a treatment with high-dose intravenous polyvalent immunoglobulins containing a high anti-CMV titre. The patient remained symptomless for more than 15 years from clinical onset and more than eight years after the discontinuation of immunological therapy. In agreement with a recent report, this case confirms that adult-onset Rasmussen's encephalitis syndrome may occur with a very mild clinical picture and persistent remission. In this case, the specific index for intrathecal production of anti-CMV antibodies suggested possible CMV involvement, indicating specific immuno-therapy as a treatment choice.
AB - A healthy 29-year-old man suffered from adult-onset epilepsy, characterized by polymorphic progressive seizures resistant to AEDs, leading to unilateral cortical deficits and atrophy of the left hemisphere. The disorder satisfied the clinical, EEG, and imaging criteria for a diagnosis of Rasmussen's encephalitis. During the acute phase of the disease, intrathecal synthesis of specific anti-CMV IgG was identified. This case was characterized by a very mild course and remission of seizures following a treatment with high-dose intravenous polyvalent immunoglobulins containing a high anti-CMV titre. The patient remained symptomless for more than 15 years from clinical onset and more than eight years after the discontinuation of immunological therapy. In agreement with a recent report, this case confirms that adult-onset Rasmussen's encephalitis syndrome may occur with a very mild clinical picture and persistent remission. In this case, the specific index for intrathecal production of anti-CMV antibodies suggested possible CMV involvement, indicating specific immuno-therapy as a treatment choice.
KW - CMV
KW - Focal epilepsy
KW - Immunoglobulins
KW - Rasmussen's encephalitis
UR - http://www.scopus.com/inward/record.url?scp=84933502041&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84933502041&partnerID=8YFLogxK
U2 - 10.1684/epd.2015.0743
DO - 10.1684/epd.2015.0743
M3 - Article
C2 - 25906060
AN - SCOPUS:84933502041
VL - 17
SP - 204
EP - 208
JO - Epileptic Disorders
JF - Epileptic Disorders
SN - 1294-9361
IS - 2
ER -