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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.
Abstract:
Subacute sclerosing panencephalitis (SSPE) is a rare, slowly progressing but invariably fatal disease that is related to a prior measles virus infection and most commonly affects paediatric patients. Magnetic resonance (MR) imaging is the modality of choice for determining such changes in white matter. SSPE typically demonstrates bilateral but asymmetric periventricular and subcortical white matter involvement. We herein report a rare case of unilateral white matter involvement in a 13-year-old boy with SSPE that closely simulated Rasmussen's encephalitis. To the best of our knowledge, this is the first report of an atypical presentation on MR imaging in which SSPE was a rare cause of unilateral brain parenchymal involvement in a patient with intractable seizures.
Insights
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.
