Atypical Presentation of Cerebral Palsy and Seizures: A case report on Rasmussen’s Encephalitis in an Adolescent

• Main Authors: Noordin, Naveed S, Deyo, Logan J, Ryon, Connor W, Anderson, Willie T, III
• Published: Digital Commons @ East Tennessee State University 2021
• Subjects: rasmussen's encephalitis; pediatric seizure; atypical presentation; pediatric rare diseases; Nervous System; Convulsive Disorders; Neurological Disorders
• Online Access: https://dc.etsu.edu/asrf/2021/presentations/62

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.