Rasmussen encephalitis is a rare autoimmune disease first described in the late 50s. It diagnosis requires multidisciplinary participation around the neuropediatrician. The diagnosis is confirmed with the association of several features: clinic, EEG, brain imaging and pathology. The Bien et al., diagnosis criterias provide good clues to retain the diagnosis of RE in the absence of cerebral biopsy. Treatment options relay on antiepileptic drugs, immunomodulator therapy and surgery. We are doing a brief report of non-usual onset of Rasmussen encephalitis and the challenging treatment decision implied in a low equipped setting.