2-[18F]-FDG PET/CT in Rasmussen Encephalitis: Guiding Diagnosis and Treatment in a Young Adult with Sudden Onset

Articles in Press

Document Type : Case report

Authors

1 Nuclear Medicine Unit, Presidio Ospedaliero Santo Spirito, Pescara, Italy.

2 Department of Medicine (DIMED), Nuclear Medicine Unit, University of Padova, Padova, Italy.

3 Department of Neuroscience, Imaging and Clinical Sciences, University G. d'Annunzio of Chieti-Pescara, Chieti, Italy. Epilespy Center, “SS Annunziata” Hospital of Chieti, University “G. d'Annunzio” of Chieti-Pescara, Chieti, Italy.

4 Department of Neuroscience, Imaging and Clinical Sciences, University G. d'Annunzio of Chieti-Pescara, Chieti, Italy.

10.22038/aojnmb.2025.84963.1606

Abstract

Rasmussen encephalitis (RE) is a rare condition characterized by chronic inflammatory disorder due to a unilateral inflammation of the cerebral cortex. Typically, it involves one cerebral hemisphere and manifests through intractable epileptic seizures. Its occurrence in adults is infrequent with late onset RE (lo-RE) being a challenging diagnosis in few cases. We present a case of a 28-year-old woman who was brought to the emergency room due to the sudden onset of uncontrolled seizures. The MRI interpretation was uncertain and the use of 2-[18F]-FDG PET/CT (FDG-PET) scan helped in the differential diagnosis between autoimmune seronegative or Rassmussen encephalitis.

Even though FDG-PET is not a mandatory diagnostic criterion in the clinical evaluation of RE patients, the presented case and the available literature data suggest its usefulness as a valuable diagnostic tool in assessing patients with doubtful diagnosis, emphasizing its potential as a reliable adjunct in challenging diagnostic scenarios and for patient follow-up.

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Asia Oceania Journal of Nuclear Medicine and Biology

Articles in Press, Accepted Manuscript
Available Online from 10 April 2025

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