Clinical profile of Subacute scelerosing panencephalitis (SSPE)

Thirty nine confirmed cases of SSPE were analysed retrospectively to study the clinical profile and to look for any atypical presentations. There were 29 males and 10 females with the age ranging from 4-19 (mean 11.5 × 3.5) years. Sixteen patients (41.0 percent) had received measles vaccination. Definite history of measles was available in 33 (84.6 percent) cases. Onset of symptoms was after 10 years of age in 58.9 percent of cases. Majority (56.42 percent) had presented within six months of onset of symptoms but 5 patients (12.8 percent) had symptoms for more than 3 years prior to the presentation. Decreased scholastic performance (58.97 percent) and myoclonus (33.33 percent) were the common presenting symptoms. Generalized tonic clonic seizures (2 cases), visual deterioration (2 cases) and altered sensorium (1 case) were the unusual presenting features. Ophthalmological manifestations were seen in 6(15.4 percent) patients. One patient had diminution of hearing in earlier stages illness. Mean age of onset of symptoms was significantly different (p < 0.01) in vaccinated (13.10 × 2.84 years) and non-vaccinated (9.87 × 3.44 years) group. Oligoclonal bands in cerebrospinal fluid (CSF) revealed a positivity in 79.4 percent of cases. Antimeasles antibody titres in serum and CSF were significantly raised in 31 cases (79.5 percent). Electroencephalogram (EEG) revealed periodic complexes in 38 cases (97.4 percent).