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Short case...Rasmussen's encephalitis

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Information about Short case...Rasmussen's encephalitis
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Published on January 21, 2009

Author: yassermetwally

Source: slideshare.net

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Short case...Rasmussen's encephalitis
http://yassermetwally.com
http://yassermetwally.net
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Short case publication... version 2.1 | Edited by professor Yasser Metwally | October 2008 Short case Edited by Professor Yasser Metwally Professor of neurology Ain Shams university school of medicine Cairo, Egypt Visit my web site at: http://yassermetwally.com A 12 years old female patient presented clinically with left sided focal motor fits with frequent postictal Todd's paralysis that started at the age of 4 years. The fits were very difficult to control medically. Epilepsia partialis continua started to occur 2 years later. At the age of 8 years the patient noticed a gradually progressive left sided hemiplegia. Progressive intellectual impairment was also a prominent feature. No speech abnormalities were appreciated clinically. DIAGNOSIS: RASMUSSEN'S ENCEPHALITIS

Figure 1. Precontrast CT scan of the brain showing prominent right hemispherical hemiatrophy with atrophy of the right cerebellar hemisphere. Also noted cortical atrophy most prominent in the right fronto-temporal area. Notice enlargement of the lateral, third ventricles on the right side with marked thinning of the white matter in the right cerebral hemisphere. The basal ganglia and thalamus on the right side are also decreased in size. There is a negative mass effect with some shift of the middle line to the right hemisphere. Notice enlargement of the basal cisterns and the interfrontal CSF spaces. The left cerebral hemisphere is not normal, showing almost the same changes observed in the right cerebral hemisphere but to a much lesser degree. Periventricular white matter changes (periventricular hypodensity) is observed bilaterally. Figure 2. Precontrast CT scan of the brain showing prominent right hemispherical hemiatrophy. Also noted cortical atrophy most prominent in the right fronto-temporal area. Notice enlargement of the lateral ventricles on the right side with marked thinning of the white matter in the right cerebral hemisphere. There is a negative mass effect with some shift of the middle line to the right hemisphere. Notice enlargement of the interfrontal CSF spaces. The left cerebral hemisphere is not normal, showing almost the same changes observed in the right cerebral hemisphere but to a much lesser degree. Periventricular white matter changes (periventricular hypodensity) is observed bilaterally.

Figure 3. A SPECT study showing decreased blood flow affecting the right cerebral and cerebellar hemisphere with maximum changes in the right fronto-temporal area. Addendum A new version of short case is uploaded in my web site every week (every Saturday and remains available till Friday.) To download the current version follow the link quot;http://pdf.yassermetwally.com/short.pdfquot;. You can download the long case version of this short case during the same week from: http://pdf.yassermetwally.com/case.pdf or visit web site: http://pdf.yassermetwally.com To download the software version of the publication (crow.exe) follow the link: http://neurology.yassermetwally.com/crow.zip At the end of each year, all the publications are compiled on a single CD-ROM, please contact the author to know more details. Screen resolution is better set at 1024*768 pixel screen area for optimum display For an archive of the previously reported cases go to www.yassermetwally.net, then under pages in the right panel, scroll down and click on the text entry quot;downloadable short cases in PDF formatquot; Also to view a list of the previously published case records follow the following link (http://wordpress.com/tag/case- record/) or click on it if it appears as a link in your PDF reader References 1. Metwally, MYM: Textbook of neurimaging, A CD-ROM publication, (Metwally, MYM editor) WEB-CD agency for electronic publishing, version 9.4a October 2008

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