Exceptional verbal intelligence after hemispherotomy in a child with Rasmussen encephalitis.
We report a longitudinal case study of a left-handed girl who underwent left hemispherotomy at 7 years for Rasmussen encephalitis (RE). Presurgical evaluation showed mild hemiparesis, no visual defect, and light neuropsychological impairment with short-term memory weakness. Language fMRI showed a right hemispheric dominance. Postoperatively, the patient exhibited right hemiplegia and hemianopsia but preserved intellectual capacities. She became seizure-free, and antiepileptic medication was discontinued. Long-term follow-up showed very high verbal intelligence at 11 years of age (VCI of 155) and improvement in working memory as well as language and reading abilities. Furthermore, a significant visuoverbal discrepancy became increasingly pronounced. Thus, early surgical treatment of epilepsy avoided the global cognitive deterioration usually associated with RE. Finally, such a high level of verbal functioning combined with low spatial reasoning with a single hemisphere provides additional information on the neurocognitive profile of children with RE after hemispherotomy.
a Inserm U663 , Paris , France.
Catherine
C
Grosmaitre
Isabelle
I
Jambaqué
Georg
G
Dorfmuller
Sebastian
S
Rodrigo
Dorothée
D
Ville
Olivier
O
Delalande
Christine
C
Bulteau
D001921:Brain / Q000503:physiopathology*; D001931:Brain Mapping; D002648:Child; D004660:Encephalitis / Q000503:physiopathology* / Q000523:psychology* / Q000601:surgery; D005260:Female; D007839:Functional Laterality / Q000502:physiology; D038421:Hemispherectomy; D006801:Humans; D007360:Intelligence / Q000502:physiology*; D007361:Intelligence Tests; D008279:Magnetic Resonance Imaging; D009483:Neuropsychological Tests; D011932:Reading
Rasmussen encephalitis; gifted child; hemispherotomy