SYSTEMATIC REVIEW Different modalities of the treatment of Rasmussen encephalitis: A systematic review of case reports of a rare disease [version 1; peer review: awaiting peer review] Rajan Chamlagain 1 , Sangam Shah 1 , Sangharsha Thapa 2 , Bipin Kandel 1 , Roman Dhital 1 , Basanta Sharma Paudel 1 , Sujan Poudel 3 , Angela Ishak 3 , Vinayak Aryal 3 , Pamela Youssef 4 , Kester J. Nedd 4 1 Tribhuvan University, Institute of Medicine, Maharajgunj, 44600, Nepal 2 Department of Neurology, Jacobs School of Biomedical Sciences, University of Buffalo, Buffalo, 14203, USA 3 Research and Academic Affairs, Larkin Community Hospital, Miami, FL, 31143, USA 4 Department of Neurology, Larkin Community Hospital Palm Springs Campus, Hialeah, FL, 33002, USA First published: 14 Sep 2022, 11:1049 https://doi.org/10.12688/f1000research.124673.1 Latest published: 14 Sep 2022, 11:1049 https://doi.org/10.12688/f1000research.124673.1 v1 Abstract Background: Rasmussen’s encephalitis (RE) is a rare chronic neurological disorder that presents with progressive neurological and cognitive deterioration, and intractable seizures that lacks definitive management. We aimed to identify case reports of RE in the literature to assess the treatment based on the symptoms and outcomes after the treatment. Methods: We searched the databases PubMed, Google Scholar, and the Cochrane Library from 1990 to 22nd February 2022 in order to review the case reports that included the treatment options and clinical outcomes of RE. A pre-established protocol was registered on the International Prospective Register of Systematic Reviews (PROSPERO) database (ID: CRD42021261999). Results: The mean age of onset of seizure was 31.44 and 6.87 years in adult onset RE and children (below 15 years of age) with RE respectively. A total of four (44.44%) out of nine adult patients and 81 (66.39%) out of 122 children underwent surgery. Tacrolimus was used in 17 (13.93%) and steroid therapy was used in 11 (9.01%) of the children. Conclusions: Large scale-controlled trials are needed to study the beneficial effect of tacrolimus, IV Ig, and plasma therapy. Hemispherectomy should be opted as a treatment modality by assessing the impairment of patients’ motor or language functions following the treatment procedure. Keywords Rasmussen encephalitis, tacrolimus, hemispherectomy, systematic review, neurological disorder, treatment Open Peer Review Approval Status AWAITING PEER REVIEW Any reports and responses or comments on the article can be found at the end of the article. Page 1 of 20 F1000Research 2022, 11:1049 Last updated: 14 SEP 2022