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Subacute sclerosing panencephalitis with bilateral inferior collicular hyperintensity on magnetic resonance imaging

Maya Thomas1, Ajith Sivadasan, Mathew Alexander

  • 1Department of Neurological Sciences, Section of Neurology, Christian Medical College, Vellore, Tamil Nadu, India.

Annals of Indian Academy of Neurology
|January 26, 2013
PubMed

Insights

Subacute sclerosing panencephalitis (SSPE), a rare complication of measles virus infection, presents with rapid neurological decline. This case highlights an uncommon MRI pattern in the inferior colliculi, crucial for diagnosing this severe encephalitis.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Pediatrics

Background:

  • Subacute sclerosing panencephalitis (SSPE) is a rare, progressive, and fatal neurological complication following measles virus infection.
  • It typically affects children and young adults, leading to severe cognitive and motor deficits.

Observation:

  • An 8-year-old boy exhibited rapid onset of behavioral changes, cognitive decline, and myoclonic jerks over two months.
  • Brain MRI revealed T2-weighted hyperintensities in subcortical occipital lobes and bilateral inferior colliculi.
  • Electroencephalogram (EEG) demonstrated bilateral, synchronous periodic discharges.

Findings:

  • Serum and cerebrospinal fluid measles IgG titers were significantly elevated, confirming measles virus infection.
  • The clinical and EEG findings were highly suggestive of SSPE.
  • The MRI pattern, particularly bilateral inferior colliculus involvement without typical white matter lesions, represents an uncommon imaging presentation of SSPE.

Implications:

  • This case underscores the importance of considering SSPE in pediatric patients with rapid neurological deterioration, even with atypical imaging findings.
  • Recognizing rare MRI patterns of SSPE is critical for timely diagnosis and management.
  • Further research into the varied neuroimaging manifestations of SSPE could improve diagnostic accuracy.
Keywords:
Brachium of inferior colliculusmeaslessubacute sclerosing panencephalitis

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