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Subacute sclerosing panencephalitis resembling Rasmussen's encephalitis on magnetic resonance imaging.
Ravi Kanth Jakkani1, Jyoti Sureka1, Sanuj Panwar2
1Department of Radiology, Christian Medical College and Hospital, Tamil Nadu, India.
Singapore Medical Journal
|October 10, 2015
Summary
Subacute sclerosing panencephalitis (SSPE), a fatal measles complication, usually affects white matter bilaterally. This report details a rare pediatric case with unilateral brain involvement mimicking Rasmussen's encephalitis on MRI.
Area of Science:
- Neurology
- Infectious Diseases
- Pediatrics
Background:
- Subacute sclerosing panencephalitis (SSPE) is a rare, fatal neurological disease linked to measles virus infection, primarily affecting children.
- Magnetic resonance (MR) imaging is crucial for diagnosing white matter changes in SSPE.
- Typical SSPE MRI findings include bilateral, asymmetric periventricular and subcortical white matter lesions.
Observation:
- A 13-year-old boy presented with intractable seizures and neurological decline.
- MR imaging revealed unilateral white matter involvement.
- The imaging findings closely mimicked Rasmussen's encephalitis.
Findings:
- This case represents a rare presentation of SSPE with unilateral brain parenchymal involvement on MR imaging.
- The atypical unilateral pattern initially suggested Rasmussen's encephalitis.
Implications:
- Recognizing atypical SSPE presentations on MRI is critical for accurate diagnosis and management.
- This case highlights the importance of considering SSPE even with unilateral findings, especially in patients with intractable seizures.
- Further research into the spectrum of SSPE neuroimaging is warranted.
