Rare presentation of subacute sclerosing panencephalitis: an acute fulminant course
نویسندگان
چکیده
Introduction: Subacute sclerosing panencephalitis (SSPE) is a progressive disease characterized by mentalneurological deterioration and myoclonus, occurring after years of measles infection. We present an atypical SSPE case, started with acute confusion and showed unusual radiological features. Case: A 10-year-old previously healthy girl addmitted with headache and constant sleepiness for a week. She has a history of measles infection by the age of nine months. She was lethargic and plantar reflexes were bilaterally indifferent. Systemic examination and biochemical evaluation were not remarkable. Brain magnetic resonance imaging (MRI) showed hyperintense lesions extending from brain stem into the cerebellar white matter. Cerebrospinal fluid examination showed 41mg/dl of protein, 57mg/dl of glucose (plasma glucose:117mg/dl), positive oligoclonal bands and IgG index >0.7. Her electroencephalography revealed disorganized background and generalized slow waves. CSF measles antibody titers were strongly positive. Intravenous (IV) metilprednisolone was given for 5 days. Because of no significant clinical response the treatment was switched to IV immunoglobuline. Following MRI showed extention of previous lesions. On the 4th week of presentation myoclonus began, the patient developed sudden cardiac arrest and died. Conclusion: Acute fulminant course and involvement of brainstem and cerebellum is rare in SSPE. Differential diagnosis may be difficult from acute confusional states. Measles serology may be useful in the management. Disclosure: Nothing to disclose PP3036
منابع مشابه
Fulminant Subacute Sclerosing Panencephalitis Presenting with Acute Ataxia and Hemiparesis in a 15-Year-Old Boy
BACKGROUND Subacute sclerosing panencephalitis (SSPE) is a delayed and fatal manifestation of measles infection. Fulminant SSPE is a rare presentation in which the disease progresses to death over a period of 6 months. The clinical features are atypical and can be misleading. CASE REPORT We report herein a teenage boy who presented with acute-onset gait ataxia followed by right hemiparesis th...
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The neurologic sequelae post-measles are less common than other complications measles-related and can lead to severe disability or death: primary measles encephalitis (PME), acute post-infectious measles encephalomyelitis (APME), measles inclusion body encephalitis (MIBE), and subacute sclerosing panencephalitis (SSPE). SSPE syndrome can affect people years from the acute measles virus infectio...
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