Status Dystonicus in Subacute Sclerosing Panencephalitis-A Rare Presentation in Emergency

Dystonia has been described in a few cases with SSPE, but there are only very few reports with status dystonicus and none from South India. Here, we report a six-year-old child presenting with severe dystonic posturing of all four limbs and trunk for 10 days duration following a febrile illness and initially treated elsewhere as viral encephalitis. Scalp EEG showed periodic high-amplitude slow wave discharges. MRI brain showed T2/FLAIR hyperintensity in bilateral frontal, left parietal, and deep white matter, extending across the corpus collosum with diffuse cerebral atrophy. The titer for IgG antibodies to measles virus by ELISA was 1:625, suggestive of SSPE. With medications, dystonia used to subside transiently; however, the patient had worsening of symptoms and showed gradual deterioration.