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A Rare Case of Subacute Sclerosing Panencephalitis Presenting As Generalized Seizure
Nabin Simkhada1, Prakash Adhikari2, Bishnu D Pathak3
1Internal Medicine, Nepalese Army Institute of Health Sciences, Kathmandu, NPL.
Abstract:
Subacute sclerosing panencephalitis (SSPE) is a late complication of childhood measles. It is characterized by a progressive decline in cognitive and motor functions, seizures, and eventually death. Although a combination of intrathecal interferon alpha (IFN-α) and daily oral isoprinosine has been reported to have a good outcome, there is no cure for this condition. We present a case of a 16-year-old male with SSPE who presented with progressive weakness, frequent loss of postural control, multiple episodes of generalized tonic-clonic seizures, and urinary incontinence. On exploration of his history, he had measles at the age of two months. Investigation showed increased serum measles antibody titer, high amplitude spikes in electroencephalogram (EEG), and high fluid-attenuated inversion recovery (FLAIR) signals on MRI of the brain consistent with probable SSPE. He was managed symptomatically until his condition got worse and he eventually passed away.
Insights
Subacute sclerosing panencephalitis (SSPE) is a fatal measles complication. This case highlights the severe progression of SSPE, emphasizing the lack of a definitive cure despite symptomatic management.
Area of Science:
- Neurology
- Virology
- Pediatrics
Background:
- Subacute sclerosing panencephalitis (SSPE) is a rare, fatal neurological complication following measles infection.
- It typically manifests years after the initial measles illness, leading to progressive neurological deterioration.
Observation:
- A 16-year-old male presented with rapid decline in motor and cognitive functions, seizures, and incontinence.
- History revealed measles infection at two months of age.
- Clinical presentation included elevated measles antibody titers, characteristic EEG abnormalities, and MRI findings consistent with SSPE.
Findings:
- The patient's condition worsened despite symptomatic treatment.
- Diagnostic investigations confirmed probable SSPE.
- The case illustrates the aggressive natural history of the disease in the absence of effective treatment.
Implications:
- This case underscores the critical need for effective preventative strategies against measles to prevent SSPE.
- Further research into novel therapeutic interventions for SSPE is warranted.
- Highlights the importance of early diagnosis and supportive care in managing SSPE patients.
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