Rasmussen encephalitis (RE) is a chronic and rare disease that causes inflammation in one side of the brain. RE mostly affects children aged 10 years and younger and can lead to seizures, memory loss, and paralysis on one side of the body.
Can IVIG help?
Free IVIG Treatment InfoIVIG, or intravenous immunoglobulin, delivers antibodies to the body that regulate the immune response and target the harmful autoantibodies that may be responsible for causing inflammation in the brain. IVIG may help slow down the progression of RE, but surgery is still the only permanent cure for seizures caused by Rasmussen encephalitis.
IVIG should not be given to patients with a history of hypersensitivity or allergic reactions to immunoglobulins. It is recommended to inform your doctor about your medical history and medication use before starting IVIG therapy.
In this article, we will discuss IVIG for Rasmussen encephalitis in detail, including its dosage, side effects, mechanism, precautions, and more.
What Is IVIG and How Does It Treat Rasmussen Encephalitis?
IVIG, also known as intravenous immunoglobulin, is an injectable medication that contains concentrated antibodies. It is made from the blood of numerous healthy donors and is injected into a person’s vein to treat immune disorders and inflammatory conditions.
IVIG treats Rasmussen encephalitis, a brain-related inflammatory disorder, by administering healthy antibodies to the body, which helps fight infection and inflammation.
It also activates the immune system to reduce brain inflammation and fight the disease. IVIG is commonly administered to patients with concurrent corticosteroid therapy unless steroid use is contraindicated.
IVIG can treat Rasmussen encephalitis by several mechanisms, including:
Neutralizing Autoantibodies
The exact cause of Rasmussen encephalitis is still unknown, but it is possible that autoantibodies are responsible for causing inflammation in the brain.
IVIG delivers thousands of healthy antibodies to the body, which binds to the harmful autoantibodies and helps neutralize them.
Anti-Inflammatory Effects
IVIG has anti-inflammatory effects that help reduce inflammation in the brain.
Stimulating Immune Functions
Thousands of healthy antibodies are injected through IVIG, which activates immune functions and stimulates the activity of immune cells, such as T cells and B cells, to help fight the disease.
Symptoms of Rasmussen Encephalitis
The common symptoms of Rasmussen encephalitis include:
- Paralysis on one side of the body
- Body weakness
- Mental decline, including learning and intellectual disabilities
- Speech difficulties
How Successful Is IVIG for Treating Rasmussen Encephalitis?
The efficacy of IVIG for Rasmussen encephalitis can vary from patient to patient, depending on their health condition and individual response to the drug. Various studies have reported the outcomes and success of IVIG:
- A study reported by Caraballo et al. suggests that IVIG may show poor response as a first-line treatment. However, when given in combination with steroids, IVIG helps improve seizure frequency and stabilizes brain damage.
- Another study published in the National Library of Medicine reported that early treatment with IVIG as soon as RE is diagnosed maximizes the effects of immunomodulation in treating seizures and controlling brain damage.
- Journal Neurology reported a case of a 27-year-old man with late-stage Rasmussen encephalitis and seizures. The administration of IVIG showed a dramatic improvement in seizure frequency, which was observed after a single dose. Monthly administration of IVIG completely stopped the occurrence of seizures and caused gradual improvement in brain and motor functions. However, stopping IVIG caused seizures to reoccur.
These studies show that IVIG is effective in controlling seizures and reducing brain damage and is a promising treatment option for Rasmussen encephalitis. IVIG is approved for use in children, but sufficient research is not available on the efficacy of IVIG in children with Rasmussen encephalitis.
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Speak to a SpecialistHow To Use IVIG
- IVIG will be administered by your healthcare provider through injection into your veins.
- IVIG is administered initially at the rate of 1 ml/kg/hour for 15 – 30 minutes. If no adverse reactions occur, the rate can be increased every 15 – 30 minutes.
- The infusion rate should not be increased to more than 3 – 6 ml/kg/hour.
- The duration of IVIG use for Rasmussen encephalitis may vary depending on individual patient needs and response to treatment.
- A visit to a neurologist is recommended after 6 months of treatment with IVIG for Rasmussen encephalitis.
- IVIG should be stored in the refrigerator at 2 – 8 °C. Avoid freezing IVIG. The shelf life of IVIG is around 24 – 36 months from the manufacturing date.
- IVIG should not be given to patients who are using blood thinners like warfarin, as it can increase the risk of bleeding.
Dose of IVIG for Rasmussen Encephalitis
IVIG is given to treat Rasmussen encephalitis in two phases:
- IVIG is first administered as an induction dose at 2g/kg in divided doses for 2 – 5 days.
- After the induction dose, IVIG is administered as a maintenance dose, which is 1g/kg in a single dose per month.
Safety Precautions
IVIG is generally a safe and effective drug, but it is crucial to monitor the following parameters to avoid any adverse reactions or organ damage:
- Signs of Infections: While receiving IVIG, signs of infections, like fever, chills, and cough should be monitored throughout the therapy.
- Kidney Function: IVIG can alter kidney function and cause kidney damage. Hence, the renal panel, fluid status, and GFR of the patient should be checked every 3 months.
- Blood Counts: IVIG can affect white blood cells and platelet count. A complete blood count profile should be monitored every 4 – 6 weeks in patients receiving long-term therapy with IVIG.
IVIG Strength
IVIG is available as an intravenous injection at the following strengths:
- 0.5 g
- 1 g
- 2.5 g
- 5 g
- 10 g
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Side Effects of IVIG
IVIG can cause the following side effects:
- Infection, like redness, irritation, or pain at the injection site
- Nausea
- Vomiting
- Headache
- Chest pain
- Back pain
- Fever or chills
- Flushing
- Rash
- Shortness of breath
- High or low blood pressure
The infusion should be stopped immediately if the side effects become severe or the following adverse effects appear:
- Reduced consciousness
- Tightening of the lungs with symptoms like wheezing and coughing
- Vomiting or chest pain
- Severe allergic reactions
- High blood pressure
- Joint stiffness
