Rasmussen’s encephalitis (RE) is a rare chronic inflammatory brain disorder resulting in progressive neurodegeneration in one cerebral hemisphere. The inflammatory process is accompanied by progressive loss of function of the affected hemisphere, associated with drug-resistant partial epilepsy. The diagnosis is based on a range of clinical, electroencephalographic, radiological and biochemical arguments, without any specific formal marker, which makes the diagnosis of the disease complex, especially in its initial phase. Seizures are refractory to anti-seizures medication (ASM) and to classical immunomodulatory treatments.
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Clinical Aspects of the Diagnosis of Epileptic Seizures
The clinician must investigate and corroborate key features of the history that help to better characterize seizures while distinguishing epileptic seizures from nonepileptic events. The most common nonepileptic paroxysmal events during childhood and adolescence are syncope, psychogenic nonepileptic events (PNES), pallid and cyanotic breath holding spells, reflux/Sandifer syndrome, self-gratification disorders, and paroxysmal nonepileptic motor disorders of sleep among others.
Clinical Criteria for Bell’s Palsy (Idiopathic Facial Nerve Paralysis)
Bell’s palsy is a peripheral palsy of the facial nerve that results in muscle weakness on one side of the face.
Clinical Criteria for Do-Not-Resuscitate (DNR) Orders in Acute Stroke
A DNR order may be written any time that two of the following clinical criteria are present and the prognosis has become clear for and shared whenever possible between physician(s), patient, and family (or appropriate surrogate).