Treatment of Rasmussen encephalitis is mostly symptomatic and supportive. Special services that may be beneficial to affected children include special social support, physical therapy, and other medical, social, and/or vocational services.
Various anti-seizure medications (anticonvulsants) may be prescribed to treat seizures. However, in most cases, anticonvulsants have proven ineffective. Medical treatments targeted at possible autoimmune disease may be tried, including steroids, immunoglobulin and tacrolimus. Immunological therapies (tacrolimus, intravenous immunoglobulins, potentially others as well) may slow down the neurological and structural deterioration but usually does not improve the epilepsy or progressive brain atrophy. Its precise role in management of Rasmussen encephalitis remains to be determined.
Surgery usually in the form of a cerebral hemispherectomy is the only way to cure the seizures and halt neurodevelopmental regression. However, there is the inevitable resultant functional deficits including hemiparesis (weakness of one side) and hemifield defect (impairment of vision to one side), and where the dominant side of the brain is affected, there may be an effect on language. The difficulty is often deciding on the necessary and best timing of surgery, dependent on the severity of epilepsy and degree of effect on learning and progression of the disease. The decision needs to be made jointly by the family and specialist center who deal with this condition regularly.