title: Young woman with a four-year history of epilepsy and progressive focal cortical atrophy - What is the diagnosis?
abstract: The pathogenesis of disease progression in drug-refractory epilepsy is poorly understood. We report the case of a young woman with a four-year history of epilepsy that progressed rapidly as evidenced by the development of progressive focal cortical atrophy. She underwent biopsy that showed perinatal ischemia and a prominent inflammatory response, including T-cell infiltration and microglial activation. There was no consensus reached on the final diagnosis although the hypothesis of dual pathology (adult variant of Rasmussen's encephalitis and perinatal stroke) was considered. The possible role of inflammation in the progression of epilepsy caused by a "static" lesion (perinatal stroke) is discussed.
authors: Epilepsy Service, Massachusetts General Hospital, Boston, MA, USA.
authors: S
authors: S
authors: Pati
authors: Neuropathology Service, Massachusetts General Hospital, Boston, MA, USA.
authors: M I
authors: MI
authors: Cobos-Sillero
authors: Neuroradiology Service, Massachusetts General Hospital, Boston, MA, USA.
authors: B
authors: B
authors: Buchbinder
authors: Neurosurgery Service, Massachusetts General Hospital, Boston, MA, USA.
authors: E
authors: E
authors: Eskandar
authors: Epilepsy Service, Massachusetts General Hospital, Boston, MA, USA.
authors: A J
authors: AJ
authors: Cole
keywords: Neuroinflammation; Perinatal stroke; Progressive epilepsy; Rasmussen's encephalitis