Difficulties in differentiation of Parry-Romberg syndrome, unilateral facial sclerodermia, and Rasmussen syndrome.
BACKGROUND
Parry-Romberg syndrome (progressive facial hemiatrophy) is a unilateral, slowly progressive atrophy affecting the skin, subcutaneous tissues, muscles, and bones. The relationship between Parry-Romberg syndrome and connective tissue disorders, especially scleroderma en coup de sabre, is still unclear. The neurological symptoms, including epilepsy, migraine, and brain lesion, on neuroimaging may be similar. Rasmussen encephalitis (RE) is connected with chronic inflammation and damage of one hemisphere. Clinically, it is manifested by epileptic partial seizures and unilateral neurological symptoms.


METHODS
The authors present the case of a 10-year-old girl with features suggestive of RE, with refractory partial motor dextrolateral seizures followed by development of hemiparesis and with progressive intellectual deterioration. At the age of 2 years, some changes on the left part of the face typical of Parry-Romberg syndrome or a linear form of scleroderma were noticed.


CONCLUSIONS
The authors discussed the difficulties in differential diagnosis in that patient. The presented girl constitute the case from the borderline zone of the aforementioned disorders.
Paprocka
Justyna
J
Departament of Pediatric Neurology, Medical University of Silesia, Katowice, Poland. justyna.paprocka@interia.pl
Jamroz
Ewa
E
Adamek
Dariusz
D
Marszal
Elzbieta
E
Mandera
Marek
M
D002540:Cerebral Cortex / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D004660:Encephalitis / Q000150:complications / Q000175:diagnosis*; D005146:Facial Asymmetry / Q000150:complications / Q000175:diagnosis*; D005150:Facial Hemiatrophy / Q000150:complications / Q000175:diagnosis*; D005260:Female; D007839:Functional Laterality; D006801:Humans; D012594:Scleroderma, Localized / Q000150:complications / Q000175:diagnosis*; D012640:Seizures / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery