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Washington University Experience | VASCULAR | Vasculitis - PACNS | 13G2 Vasculitis (Case 13) 2-14-2019 T2 FLAIR - Copy

The most recent MRIs in this patient show marked atrophy but no ongoing FLAIR activity. ---- Denouement: The patient’s treatment history included pulse methyl-prednisolone following diagnosis, then six months of cyclophosphamide with a prolonged prednisone taper. She was transitioned to azathioprine in August 2015 and has remained on that regimen ever since. The patient has been doing well; however, she continues to have daily, transient sharp headaches that she described as a sharp pain usually over her right temple and sometimes left temple and down the right side of her face that last about a minute. She also reported episodes of face tightness that happen about once per month. ---- This case remains an enigma with features of Rasmussen’s encephalitis (seizures, hemiatrophy) but not microglial nodules or neuronophagia.

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