Refractory occipital lobe epilepsy treated by surgery in a child with chronic encephalitis.

An 11-year-old boy developed catastrophic occipital lobe epilepsy with progressive neurocognitive decline which led to surgical treatment. Pathological examination of the resected epileptic area showed chronic inflammatory changes. Surgery was followed by a subacute and regressive encephalopathy although the patient did not suffer further seizures. We suggest that this occipital lobe epilepsy was related to chronic nonprogressive encephalitis consistent with a variant of Rasmussen's syndrome, and that the immune and/or inflammatory process was reactivated by surgery. This case indicates that there is no direct link between the epileptic and the encephalitic processes.