title: Functional hemispherotomy in Rasmussen syndrome in the absence of classic MRI findings.
abstract: A 7-year-old previously healthy girl presented with a left-sided focal seizure without impaired consciousness and subsequently developed epilepsia partialis continua. Initial MRI was normal, and the subsequent images only showed a focal T2/FLAIR hyperintense area without cortical atrophy. She was diagnosed with Rasmussen syndrome by pathology and promptly treated with functional hemispherotomy. Rasmussen syndrome is a rare progressive neurological disorder, the only definitive cure for which is hemispheric disconnection. The disease presents a management dilemma, especially early in disease course without characteristic neuroimaging features. A high index of suspicion, multidisciplinary approach, and clear timely communication with the family are critical.
authors.affiliation: Department of Neurosurgery, University of Iowa Hospitals and Clinics, Iowa City, IA, USA.
authors.forename: Yasunori
authors.initials: Y
authors.lastname: Nagahama
authors.affiliation: Department of Pediatrics, University of Iowa Hospitals and Clinics, Iowa City, IA, USA.
authors.forename: Charuta
authors.initials: C
authors.lastname: Joshi
authors.affiliation: Department of Neurosurgery, University of Iowa Hospitals and Clinics, Iowa City, IA, USA.
authors.forename: Brian
authors.initials: B
authors.lastname: Dlouhy
authors.affiliation: Department of Pathology, University of Iowa Hospitals and Clinics, Iowa City, IA, USA.
authors.forename: Angela Y
authors.initials: AY
authors.lastname: Wu
authors.affiliation: Department of Neurosurgery, University of Iowa Hospitals and Clinics, Iowa City, IA, USA.
authors.forename: Taylor J
authors.initials: TJ
authors.lastname: Abel
authors.affiliation: Department of Pathology, University of Iowa Hospitals and Clinics, Iowa City, IA, USA.
authors.forename: Gary
authors.initials: G
authors.lastname: Baumbach
authors.affiliation: Department of Neurosurgery, University of Iowa Hospitals and Clinics, Iowa City, IA, USA.
authors.forename: Hiroto
authors.initials: H
authors.lastname: Kawasaki
keywords: ASDs, antiseizure drugs; EEG, electroencephalogram; EPC, epilepsia partialis continua; EVD, external ventricular drain; Early diagnosis; Functional hemispherectomy; MRI, magnetic resonance imaging; PET, positron emission tomography; Peri-insular functional hemispherotomy; RS, Rasmussen syndrome; Rasmussen syndrome; Rasmussen's encephalitis