A Case Series of Adult-Onset Rasmussen's Encephalitis: Diagnostic and Therapeutic Challenges.

A Case Series of Adult-Onset Rasmussen's Encephalitis: Diagnostic and Therapeutic Challenges.
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DOI:
10.3389/fneur.2017.00564
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发表时间:
2017
影响因子:
3.4
通讯作者:
Lado FA
Lado FA
中科院分区:
医学3区
文献类型:
--
作者:
Castellano JF;Meyer JA;Lado FA

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拉斯穆森脑炎(RE)是一种罕见的神经系统疾病,其特征是进行性大脑偏侧萎缩和药物难治性癫痫。目前关于这一主题的大多数文献都集中在儿科人群。在这个病例系列中,我们将回顾三例成人发作RE,定义为满足2005年Bien标准。在所有三名患者中,广泛的血清、CSF和病理学采样将突出说明这种罕见疾病的诊断挑战。随着时间的推移,将检查MR成像和EEG数据,以表征标志性发现以及进展。此外,我们将审查各种形式的治疗尝试在这三个病人,即抗癫痫药物治疗和免疫调节治疗。我们也将利用这个病例系列来批判性地评估这种疾病的非典型表现的更广泛的背景和当前诊断标准的价值。
Rasmussen’s encephalitis (RE) is a rare neurologic disorder characterized by progressive cerebral hemiatrophy and medically refractory epilepsy. The majority of current literature on this topic is focused on the pediatric population. In this case series, we will review three cases of adult-onset RE, as defined by fulfillment of the 2005 Bien criteria. The diagnostic challenge of characterizing this rare disease will be highlighted by the extensive serum, CSF, and pathologic sampling in all three patients. MR imaging and EEG data will be examined over time to characterize hallmark findings as well as progression. In addition, we will review the various forms of therapy attempted in these three patients, namely anti-epileptic drug therapy and immunomodulatory therapy. We will also utilize this case series to critically evaluate the broader context of atypical presentations of this disease and the value of current diagnostic criteria.
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