Rasmussen's encephalitis and the new hat

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Abstract
The prototype case of the syndrome now designated as Rasmussen's encephalitis was identified in 1941 in a 7-year-old boy who developed right-sided seizures and subsequently slight right arm weakness; a left cortical biopsy revealed encephalitis. [1] By 1945 he had progressed to moderate right hemiparesis. A larger cortical resection again indicated inflammation. Seizures continued and right hemiplegia and hemianopia evolved. A left hemispherectomy was performed in 1956; sparse perivascular inflammation and glial nodules were found. Dr. Wilder Penfield, consulting in this case, raised the issues which continue to be debated to the present day. Is the encephalitic process the primary abnormality or a secondary response to the recurrent seizures? Why should an encephalitic process be unilateral? Can recurrent seizures lead to tissue destruction? Dr. Penfield, skeptical of the postulate that the syndrome was a primary inflammatory disorder, offered a new hat to anyone who proved him wrong.