INTRODUÇÃO: A encefalite de Rasmussen (ER) é uma doença rara e esporádica, apresentando-se como uma síndrome com disfunção cerebral multifocal e convulsões focais refratárias ao tratamento medicamentoso, por vezes se manifestando com epilepsia parcial contínua. O início das crises focais predomina na infância e afeta crianças previamente hígidas, com curso progressivo. Na maioria das vezes envolve apenas um hemisfério cerebral, que se torna atrófico. O diagnóstico é feito através da análise do eletroencefalograma, características clínicas, achados de ressonância magnética (RM) e/ou achados histopatológicos. A RM encefálica é particularmente útil no estudo destes doentes, fornecendo dados que podem contribuir para o diagnóstico, ajudar na seleção do local para biópsia, assim como no acompanhamento da evolução progressiva da doença. MATERIAIS E MÉTODOS: Foram coletados os dados demográficos, avaliações neuropsicológicas, dados cirúrgicos e achados de imagem de todos os pacientes diagnosticados com ER no HCFMRP, de 1997-2016. RESULTADOS: Foram incluídos 35 pacientes com média de idade de 5,8 anos. Setenta por cento destes apresentaram-se com epilepsia parcial contínua e 29 tiveram também a confirmação histopatológica. Não houve nenhum caso de acometimento bilateral confirmado nesta amostra. Os achados de imagem mais comuns foram alteração de sinal, atrofia focal ou hemisférica e dilatação ventricular, em graus variados. Trinta e três pacientes foram submetidos ao tratamento cirúrgico. CONCLUSÕES: A definição da conduta e tratamento dos pacientes com ER deve ser discutida por equipe multidisciplinar, levando em consideração os achados clínicos, EEG e de exames de imagem, com objetivo de controlar as crises a fim de minimizar os déficits cognitivos, motores e de linguagem destes pacientes. / INTRODUCTION: Rasmussen encephalitis (RE) is a rare and sporadic disease, presenting as a multifocal brain dysfunction and focal seizures, refractory to drug treatment, sometimes manifesting with continuous partial epilepsy. The onset of seizures predominates in childhood, and affects previously healthy children with progressive course. Most often involves one cerebral hemisphere, which becomes atrophic. Diagnosis is made through EEG analysis, clinical, magnetic resonance imaging (MRI) findings and/or histopathological findings. Brain MRI is particularly useful, and provides data that can contribute to the diagnosis, help in site selection for biopsy, as well as in monitoring the progressive course of the disease. MATERIALS AND METHODS: We collected demographic data, neuropsychological evaluations, surgical and imaging findings of all patients diagnosed with RE in HCFMRP, from 1997-2016. RESULTS: It included 35 patients with a mean age of 5.8 years. Seventy percent of these presented with continuous partial epilepsy and 29 also had histopathologic confirmation. There were no cases of confirmed bilateral involvement in this sample. The most common imaging findings were signal change , focal or hemispheric atrophy and ventricular dilatation , in varying degrees. Thirtythree patients underwent surgical treatment. CONCLUSIONS: The definition of management and treatment of patients with ER should be discussed by a multidisciplinary team, taking into account the clinical, EEG and imaging findings, in order to control seizures and minimize cognitive, motor and language deficits of these patients.

INTRODUÇÃO: A encefalite de Rasmussen (ER) é uma doença rara e esporádica, apresentando-se como uma síndrome com disfunção cerebral multifocal e convulsões focais refratárias ao tratamento medicamentoso, por vezes se manifestando com epilepsia parcial contínua. O início das crises focais predomina na infância e afeta crianças previamente hígidas, com curso progressivo. Na maioria das vezes envolve apenas um hemisfério cerebral, que se torna atrófico. O diagnóstico é feito através da análise do eletroencefalograma, características clínicas, achados de ressonância magnética (RM) e/ou achados histopatológicos. A RM encefálica é particularmente útil no estudo destes doentes, fornecendo dados que podem contribuir para o diagnóstico, ajudar na seleção do local para biópsia, assim como no acompanhamento da evolução progressiva da doença. MATERIAIS E MÉTODOS: Foram coletados os dados demográficos, avaliações neuropsicológicas, dados cirúrgicos e achados de imagem de todos os pacientes diagnosticados com ER no HCFMRP, de 1997-2016. RESULTADOS: Foram incluídos 35 pacientes com média de idade de 5,8 anos. Setenta por cento destes apresentaram-se com epilepsia parcial contínua e 29 tiveram também a confirmação histopatológica. Não houve nenhum caso de acometimento bilateral confirmado nesta amostra. Os achados de imagem mais comuns foram alteração de sinal, atrofia focal ou hemisférica e dilatação ventricular, em graus variados. Trinta e três pacientes foram submetidos ao tratamento cirúrgico. CONCLUSÕES: A definição da conduta e tratamento dos pacientes com ER deve ser discutida por equipe multidisciplinar, levando em consideração os achados clínicos, EEG e de exames de imagem, com objetivo de controlar as crises a fim de minimizar os déficits cognitivos, motores e de linguagem destes pacientes. / INTRODUCTION: Rasmussen encephalitis (RE) is a rare and sporadic disease, presenting as a multifocal brain dysfunction and focal seizures, refractory to drug treatment, sometimes manifesting with continuous partial epilepsy. The onset of seizures predominates in childhood, and affects previously healthy children with progressive course. Most often involves one cerebral hemisphere, which becomes atrophic. Diagnosis is made through EEG analysis, clinical, magnetic resonance imaging (MRI) findings and/or histopathological findings. Brain MRI is particularly useful, and provides data that can contribute to the diagnosis, help in site selection for biopsy, as well as in monitoring the progressive course of the disease. MATERIALS AND METHODS: We collected demographic data, neuropsychological evaluations, surgical and imaging findings of all patients diagnosed with RE in HCFMRP, from 1997-2016. RESULTS: It included 35 patients with a mean age of 5.8 years. Seventy percent of these presented with continuous partial epilepsy and 29 also had histopathologic confirmation. There were no cases of confirmed bilateral involvement in this sample. The most common imaging findings were signal change , focal or hemispheric atrophy and ventricular dilatation , in varying degrees. Thirtythree patients underwent surgical treatment. CONCLUSIONS: The definition of management and treatment of patients with ER should be discussed by a multidisciplinary team, taking into account the clinical, EEG and imaging findings, in order to control seizures and minimize cognitive, motor and language deficits of these patients.

The thesis "Effects of surgery treatment of epilepsy on psychosocial condition of the patients" deals with the disease which causes many social effects on the patients. The most frequent ones are limitations in the working life and mental problems. I am interested in the epilepsy issue and therefore I have selected this topic which continues the bachelor thesis written in 2008. The objective of my work was to determine effects of epileptosurgery on the work life and on the mental area. Two hypotheses were established which assumed that the surgical treatment improved the patient´s life both in the working and in the mental spheres. The hypotheses were tested by means of quantitative research; questionnaires were used for the collection of data and the respondents were adult patients, who underwent surgical treatment of epilepsy and have been in the care of the Center of Epilepsy Na Homolce in Prague, and patients in the care of neurology departments in České Budějovice and in Strakonice. The results have shown that the epileptosurgery failed to improve the lives of the patients in the working sphere and thus the first hypothesis was not confirmed. Many of the patients are still unemployed and they still find it difficult to find jobs. The offer of vacancies has not increased much after the surgery. Those who work often feel stress and anxiety as a result. Some patients even lost jobs after the surgery or their working positions do not correspond to the achieved qualification level, experience and potential. The improvement in the mental area has been confirmed and many of the patients no more suffer from mental problems they had before the surgery. In some of the respondents mental disorders diminished or disappeared entirely. They are more self-confident, more even-tempered and they need less professional help. In this area I see the effects of surgical treatment as very beneficial. The results of my thesis might be used in publications for the general public, as well as for professionals specializing in the field.