Atypical Presentation of Cerebral Palsy and Seizures: A Case Report on Rasmussen's Encephalitis in an Adolescent.
Atypical Presentation of Cerebral Palsy and Seizures: A Case Report on Rasmussen's Encephalitis in an Adolescent.
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DOI：
10.7759/cureus.13705
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发表时间：
2021-03-04
期刊：
影响因子：
--
通讯作者：
Anderson WT
中科院分区：
文献类型：
--
作者：
Noordin NS;Deyo LJ;Ryon CW;Anderson WT
拉斯穆森脑炎是一种罕见的神经系统疾病，于1958年首次描述，其特征是药物难治性癫痫发作，局灶性单侧脑炎症和轻偏瘫等缺陷。虽然我们仍然没有对这种疾病有充分的了解，但其病因学背后的理论包括自身免疫表现，T细胞的免疫攻击和基因表达的功能异常。它通常被认为是一种罕见的儿童疾病，发病年龄中位数为6岁，青少年和成年人的病例更罕见，迄今为止占所有病例的10%。在这份报告中，我们想分享一个罕见的病例拉斯穆森脑炎发生在青少年。我们的17岁男性患者从14岁开始出现体征和症状，最初被诊断为脑瘫，后来出现其他症状和特征性EEG和MRI结果，最终导致诊断为拉斯穆森脑炎。因此，通过这份病例报告，我们的目的是双重的：阐明一种已经罕见的疾病的非典型表现，在青少年和成人中甚至更罕见，并强调在评估癫痫患者时保持广泛差异的重要性。
Rasmussen’s encephalitis is a rare neurological disease first described in 1958 that is characterized by medico-refractory seizures, focal unilateral cerebral inflammation, and deficits such as hemiparesis. While we still do not have a full understanding of this disease, proposed theories behind its etiology include auto-immune manifestations, immune attack by T cells, and malfunctional alterations in genetic expression. It is classically considered a rare childhood malady with a median age of onset of six years, and cases in adolescents and adults are even rarer, representing up to 10% of all cases to date. In this report, we would like to share a rare case of Rasmussen's encephalitis that occurred in an adolescent. Our 17-year-old male patient presented with signs and symptoms beginning at age 14 and was initially diagnosed with cerebral palsy only to later present with additional symptoms and characteristic EEG and MRI findings that ultimately led to a diagnosis of Rasmussen’s encephalitis. Thus, with this case report, our intent is twofold: to shed light on an atypical presentation of an already rare disease, even rarer in adolescents and adults, and to underscore the importance of keeping a broad differential when it comes to evaluating a patient with seizures.
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