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Subacute sclerosing panencephalitis in pregnancy.
Michael H Chiu1, Bonnie Meatherall1, Ana Nikolic2
1Department of Medicine, Division of Internal Medicine, University of Calgary, Calgary, AB, Canada.
The Lancet. Infectious Diseases
|January 27, 2016
Summary
A previously healthy pregnant woman developed subacute sclerosing panencephalitis (SSPE) after traveling in India. Autopsy confirmed SSPE, highlighting its rare occurrence and severe prognosis.
Area of Science:
- Neurology
- Infectious Diseases
- Maternal-Fetal Medicine
Background:
- Subacute sclerosing panencephalitis (SSPE) is a rare, progressive neurological disorder caused by persistent measles virus infection.
- SSPE typically affects children and adolescents, with adult-onset cases being exceptionally uncommon.
Observation:
- A 29-year-old pregnant woman presented with cognitive decline and functional impairment during her second trimester.
- Despite initial suspicion of autoimmune encephalitis, extensive investigations were inconclusive.
- The patient's condition rapidly deteriorated, leading to coma and requiring an emergency cesarean delivery.
Findings:
- Autopsy confirmed subacute sclerosing panencephalitis (SSPE) as the cause of the patient's fatal illness.
- The case highlights the potential for SSPE to manifest in adults, particularly following exposure to measles virus.
- The infant delivered via cesarean section appeared healthy at birth.
Implications:
- This case underscores the importance of considering SSPE in the differential diagnosis of unexplained neurological deterioration in pregnant women, especially with a history of travel to endemic areas.
- Public health strategies for measles vaccination remain crucial in preventing SSPE.
- Further research into adult-onset SSPE and its management in pregnancy is warranted.
