Abstracts

Rationale: Presenting of 20 cases with Rasmussen's encephalitis(RE) being surgically treated, to observe the clinical effects after 3 to 54months follow-up. Methods: Retrospectively analyze the clinical data of 20 cases with RE in our epilepsy center from April 2004 to June 2009. Of the 20 cases, 9 were males and 11 were females. The age of onset was from 1.7 to 17 years (average 5.7) and disease duration of 5 months to 12 years (average 3.6). Different operations had been made based on the pre-operation evaluations (Adame s Modified hemispherectomy, functional hemispherectomy, hemispherotomy and selectively epileptogenic zone resection. Regular follow-up of all cases after operation was made. Results: 4 cases were operated with Adame s Modified hemispherectomy (AH), 10 case were operated with functional hemispherectomy(FH) and 5 cases with hemispherotomy, 1 cases with selectively epileptogenic zone resection. During 3 to 54 months follow-up, 16cases had seizure free (Engel I, 80%) , 3 cases with alleviation of seizures (1 cases with Engel class II and 1 with Engel class III), 1 case had frequent seizures after operation(probably bilateral RE). After operation, most patient are able to walk without the use of assistive devices except one case, but the fine motor hand movements were lost. Conclusions: RE is a drug-resistant epilepsy syndromes accompanied by progressive neurological deterioration. Hemispherectomy is a viable alternative, which should be considered in the treatment of RE based on the pre-evaluations, various operation methods (AH, FH, hemispherotomy) don t influence seizure outcome, but the long-term effect remains to be observe.