Subacute sclerosing panencephalitis presenting as schizophreniform psychosis

Area of Science:

• Neurology
• Psychiatry
• Virology

Background:

• Subacute sclerosing panencephalitis (SSPE) is a rare, progressive neurological disorder caused by persistent measles virus infection.
• SSPE typically affects children and young adults, leading to severe cognitive decline, motor deficits, and seizures.
• While neurological symptoms are characteristic, atypical presentations involving psychiatric disturbances are increasingly recognized.

Observation:

• A 21-year-old woman presented with acute-onset paranoid schizophreniform symptoms.
• Initial psychiatric evaluation did not immediately suggest an underlying organic cause.
• Subsequent investigations revealed the patient had subacute sclerosing panencephalitis.

Findings:

• The case demonstrates that subacute sclerosing panencephalitis can present with prominent psychiatric manifestations, mimicking primary psychiatric disorders.
• Neuroimaging and cerebrospinal fluid analysis confirmed the diagnosis of SSPE.
• The patient's psychiatric symptoms improved with supportive care, but the underlying neurological condition progressed.

Implications:

• This case underscores the importance of considering rare neurological conditions like SSPE in the differential diagnosis of new-onset psychosis, particularly in young individuals.
• Early recognition of SSPE, even with atypical psychiatric symptoms, is crucial for appropriate management and patient counseling.
• Further research into the neurobiological mechanisms linking viral encephalitis and psychiatric symptoms in SSPE is warranted.