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Case Report: Subacute Sclerosing Panencephalitis in Pregnancy Mimicking Posterior Reversible Encephalopathy Syndrome

Praveen Kumar Sharma1, Ravindra Kumar Garg, Shinu Singla1

  • 1Department of Neurology, King George Medical University (KGMU), Lucknow, India.

The American Journal of Tropical Medicine and Hygiene
|January 24, 2020
PubMed

Insights

Subacute sclerosing panencephalitis (SSPE) can mimic postpartum eclampsia, causing vision loss and brain MRI changes. Early diagnosis is crucial to avoid incorrect treatment, such as magnesium sulfate.

Area of Science:

  • Neurology
  • Radiology
  • Infectious Disease

Background:

  • Posterior reversible encephalopathy syndrome (PRES) is characterized by reversible brain MRI abnormalities, often linked to eclampsia in pregnancy.
  • Eclampsia is a common cause of PRES, presenting with neurological symptoms and characteristic imaging findings.

Observation:

  • A postpartum woman presented with bilateral vision loss and myoclonic jerks, initially suspected as eclampsia.
  • Brain MRI revealed parieto-occipital white matter hyperintensities, similar to PRES.
  • Cerebrospinal fluid analysis showed elevated anti-measles antibody titers.

Findings:

  • The patient was diagnosed with subacute sclerosing panencephalitis (SSPE), not eclampsia.
  • The brain MRI findings in SSPE can mimic PRES, particularly in the postpartum period.
  • The vision loss and neurological symptoms resolved significantly after 5 months.

Implications:

  • SSPE can present with symptoms and imaging findings that closely resemble PRES and eclampsia in the postpartum period.
  • Misdiagnosis of SSPE as eclampsia may lead to unnecessary magnesium sulfate treatment.
  • This case highlights the importance of considering rare neurological conditions in the differential diagnosis of postpartum neurological symptoms.

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