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Epilepsia partialis continua in children with fulminant subacute sclerosing panencephalitis

Ruzica Kravljanac1, Nebojsa Jovic, Milena Djuric

  • 1Institute for Mother and Child Health, University of Belgrade, 6-8 Radoje Dakic Street, 11070 Belgrade, Serbia. djruzica@eunet.rs

Neurological Sciences : Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology
|November 6, 2010
PubMed

Insights

Epilepsia partialis continua can occur in the late stages of subacute sclerosing panencephalitis, a rare measles complication. This rare presentation in unvaccinated children indicates a rapidly fatal disease course.

Area of Science:

  • Neurology
  • Infectious Diseases

Background:

  • Subacute sclerosing panencephalitis (SSPE) is a rare, progressive neurological disorder caused by persistent measles virus infection.
  • Inflammatory central nervous system diseases, including SSPE, can manifest as epilepsia partialis continua (EPC).

Observation:

  • Two unvaccinated boys presented with EPC during the terminal phase of atypical SSPE.
  • Both cases exhibited rapid cognitive and neurological decline, with one experiencing complex partial seizures and myoclonic jerks.

Findings:

  • Diagnosis of SSPE was confirmed by elevated antimeasles antibodies in serum and cerebrospinal fluid.
  • EPC in the terminal SSPE phase responded to midazolam but lacked typical EEG epileptic discharges.
  • The disease course was fulminant, with survival less than three months from onset to death.

Implications:

  • EPC may be an underrecognized manifestation of advanced SSPE.
  • This highlights the critical importance of measles vaccination to prevent SSPE.
  • The rapid progression underscores the severity of SSPE, even in atypical presentations.

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