A patient with progressive right hemiparesis, left hemispheric atrophy, and brain pathologic features characteristic for Rasmussen encephalitis (RE) is reported.

She had no seizures for over 2 years after her symptom onset and for several months during follow-up.

This report expands the clinical spectrum of RE and suggests that seizures are not a universal symptom of RE.

This report also suggests that unilateral hemispheric progressive inflammation in RE can occur without seizure activity.