Epilepsia Partialis Continua Secondary to Rasmussen Encephalitis: A Rare Presentation

Abstract

The case report describes the disease condition of a 7-year-old female who was pre-morbidly a normal child, and was apparently well before 6 months when she developed a fever which was intermittent, high grade, and not associated with chills and partially responding to medication. Fever has been onoff throughout the course of illness but has reduced significantly over the last 2 months. Gradually, she started showing symptoms of deviation of eyes towards the right side, head deviation to right side followed by twitching of eyebrows to the right side and angle of mouth to the right side, and seizures in the right lower limb. The episode lasted for 5–7 min, child continued to have similar episodes 1–2 per day, and over the next one month. The child also presented with a gradual decline in school performance in the form of difficulty in reciting poems. The child was presented with the above complaints in the emergency department and was given midazolam 2 mg stat and seizures aborted thereafter, the possibility of Epilepsia partialis continua secondary to Rasmussen encephalitis was kept. MRI from the outside hospital was discussed and was significant of cortical atrophy involving left hemisphere with hyperintensities in the left parietal and temporal regions with gliosis in the left insular region. The patient was admitted to the neurology ward of a tertiary care hospital and is planned for hemispherectomy after confirming the more precise focal origin of seizure with video EEG.