Rasmussen's encephalitis

Question 1

describe rasmussen’s encephalitis

Answer 1

a chronic, progressive inflammatory disorder that affects one hemisphere of the brain characterized by seizures, hemiparesis, and progressive cognitive decline

Question 2

what is the cause/suggested cause of rasmussen’s encephalitis

Answer 2

it is rare and cause is unknown
suggested that brain inflammation may be due to reaction of foreign antigen or autoimmune disease confined to one hemisphere of the brain

Question 3

describe the autoimmune features of rasmussen’s encephalitis

Answer 3

antibodies and T cells begin to fight its own tissue

Question 4

what possible infections can be blamed for rasmussen’s encephalitis

Answer 4

influenza, measles, chickenpox, cytomegalovirus

Question 5

what are the 3 stages of rasmussen’s encephalitis and describe each

Answer 5

• prodromal (7mo): not a lot of seizures
• acute (8mo): increase in seizure activity, hemiparesis, decrease cognitive function, aphasia
• residual: continuing seizures and permenant but stable neurological deficits

Question 6

s/s rasmussen’s encephalitis

Answer 6

• focal seizures that can progress to continuous seizures known as epilepsia partialis continua (EPC)
• contralateral hemiparesis
• developmental arrest in children
• progressive cognitive deficits
• aphasia, dyarthria, dysphagia, hemianopsia
• language and cognitive disturbances often occur with L hemisphere invovlement

Question 7

prevalence rasmussen’s encephalitis

Answer 7

• most often in kids under 10
• most common at ages 6-8
• adults can also be affected
• can progress slowly with aging
• children with RE frequently enter stage of permanent but stable neurologic deficits after 8-12 months

Question 8

dx rasmussen’s encephalitis

Answer 8

• based on clincal sx and results of radiological findings
• electroencephalography (EEG) for brainwave patterns for epilepsy
• MRI to show progressive atrophy and scarring of affected side of brain

Question 9

red flags rasmussen’s encephalitis

Answer 9

loss of consciousness
sudden onset seizures
sudden changes in vision/breathing
sudden changes in speech

Question 10

PT systems review rasmussen’s encephalitis

Answer 10

• neuro exam - cognition, sensation, motor, tone, CN 2, 3, 4, 6, 9, 10, 12
• gait
• functional strength

Question 11

tx rasmussen’s encephalitis

Answer 11

• antiepileptic drugs (AED) to control seizures
• immunotherapy to suppress or modulate immune system (corticosteroids, intravenous immunoglobulin, tacrolimus
• surgery to control seizures (hemispherectomy)

Question 12

PT working diagnosis rasmussen’s encephalitis

Answer 12

cerebral hemiatrophy
hemiplegia
genetic disorders
vasculitis following infection
CNS pathology/tumor

Question 13

PT expected outcomes rasmussen’s encephalitis

Answer 13

• gain function (strength, coordination, balance, gait) depending on severity and age
• communication with OT, SLP, PCP, neurology

Question 14

PT POC rasmussen’s encephalitis

Answer 14

WB activities on involved side
gait training
balance and postural control
activities alternating BOS
transfers
pt education