Adult-onset subacute sclerosing panencephalitis

Area of Science:

• Neurology
• Virology
• Neuroimmunology

Background:

• Subacute sclerosing panencephalitis (SSPE) is a fatal neurological disease caused by a defective measles virus, typically affecting children.
• Adult-onset SSPE is uncommon and can manifest as rapidly progressive dementia, complicating diagnosis.

Purpose of the Study:

• To report a case of adult-onset SSPE presenting as rapidly progressive dementia in a young man of Indian origin.
• To highlight diagnostic challenges and key indicators for SSPE in adults.

Main Methods:

• Case presentation of a young adult with dementia.
• Magnetic resonance imaging (MRI) of the brain revealing parieto-occipital white matter changes.
• Cerebrospinal fluid (CSF) analysis for high titres of anti-measles antibodies.

Main Results:

• The patient presented with rapidly progressive dementia without focal neurological signs.
• MRI showed characteristic white matter abnormalities.
• Elevated anti-measles antibody titres in CSF confirmed SSPE diagnosis.

Conclusions:

• Adult-onset SSPE is a rare but critical differential diagnosis for rapidly progressive dementia, particularly in adults from areas with suboptimal measles vaccination.
• The long latency period between measles infection and SSPE onset can be misleading.
• Prompt diagnosis relies on recognizing subtle neurological signs and specific serological markers.