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Neurology 2003;60:140-142
© 2003 American Academy of Neurology
Brief Communications

Persistence of ictal activity after functional hemispherectomy in Rasmussen syndrome

Pierre Thomas, MD, Benjamin Zifkin, MD, Gabriela Ghetâu, MD and Olivier Delalande, MD

From the Service de Neurologie (Drs. Thomas and Ghetâu), Hôpital Pasteur, Nice, and Service de Neurochirurgie (Dr. Delalande), Fondation Ophtalmologique A. de Rothschild, Paris, France; and Hôpital du Sacré-Coeur de Montréal (Dr. Zifkin), Faculté de Médecine, Université de Montréal, Montréal, Quebec, Canada.

Address correspondence and reprint requests to Dr. Pierre Thomas, Service de Neurologie, Hôpital Pasteur, 30 Voie Romaine, B.P. 69, 06002 Nice Cedex 01, France; e-mail: piertho{at}wanadoo.fr

A 15-year-old girl with a 3-year history of Rasmussen syndrome (RS) underwent left functional hemispherectomy by central disconnection. Clinical seizures then ceased. Five months postoperatively, ictal EEG discharges were associated with focal hyperperfusion on SPECT within the disconnected hypoperfused left hemisphere, suggesting that the basic mechanisms of RS may continue, only to remit later. EEG and SPECT may complement studies of these in seizure-free surgically treated patients in whom clinical follow-up may be unrevealing.




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