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Atypical electroencephalographic pattern in a patient with subacute sclerosing panencephalitis

G B Sharp1, S M Laney, B F Westmoreland

  • 1Section of Pediatric Neurology, Mayo Clinic, Rochester, MN 55905.

Electroencephalography and Clinical Neurophysiology
|April 1, 1991
PubMed

Insights

Subacute sclerosing panencephalitis (SSPE), a rare measles complication, presents with progressive dementia and seizures. Diazepam administration revealed typical periodic complexes on EEG, aiding diagnosis in this atypical case.

Area of Science:

  • Neurology
  • Virology
  • Pediatrics

Background:

  • Subacute sclerosing panencephalitis (SSPE) is a rare, progressive neurological complication of measles virus infection.
  • Widespread measles vaccination has significantly reduced SSPE incidence globally.
  • SSPE typically manifests with cognitive decline, seizures, and characteristic EEG abnormalities.

Observation:

  • A patient presented with a 5-month history of seizures and progressive dementia attributed to SSPE.
  • The initial electroencephalogram (EEG) showed an atypical pattern of generalized spike-and-wave discharges, predominantly on the right side, coinciding with clinical seizures.
  • Intravenous diazepam administration was administered to the patient.

Findings:

  • Following diazepam administration, the EEG pattern evolved to display more typical periodic complexes.
  • This EEG change suggests a potential diagnostic utility of pharmacologic challenge in atypical SSPE cases.
  • The findings highlight the variability in EEG presentation of SSPE.

Implications:

  • Recognizing atypical EEG patterns in SSPE is crucial for timely diagnosis and management.
  • Pharmacologic interventions like diazepam may help unmask characteristic EEG findings in challenging SSPE cases.
  • Continued surveillance and vaccination remain paramount in preventing SSPE.

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