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The Rare Case Presentation of Adult-Onset Fulminant Subacute Sclerosing Panencephalitis in a 24-Year-Old Male

Nikhil Malunjkar1, Pradeep Tiwari1, Neha Momale1

  • 1General Medicine, Padmashree Dr. D.Y. Patil School of Medicine, Nerul, IND.

Cureus
|October 10, 2024
PubMed

Insights

Subacute sclerosing panencephalitis (SSPE) is a rare measles complication. A combination treatment of intrathecal interferon-α and oral isoprinosine shows promise for managing this severe neurological disorder.

Area of Science:

  • Neurology
  • Pediatrics
  • Infectious Diseases

Background:

  • Subacute sclerosing panencephalitis (SSPE) is a devastating late complication of measles infection.
  • It leads to progressive neurological decline, cognitive impairment, and ultimately death in affected children.
  • Currently, no definitive cure exists for SSPE.

Observation:

  • A 24-year-old male presented with spastic seizure epilepsy, progressive weakness, and postural instability.
  • Clinical presentation included recurrent generalized tonic-clonic seizures.
  • Diagnostic findings revealed elevated measles antibodies in cerebrospinal fluid (CSF).

Findings:

  • Electroencephalogram (EEG) showed prominent amplitude spikes, characteristic of SSPE.
  • Brain magnetic resonance imaging (MRI) with fluid-attenuated inversion recovery (FLAIR) sequences demonstrated significant abnormalities.
  • The combination of clinical, CSF, EEG, and MRI findings strongly supported the diagnosis of SSPE.

Implications:

  • The case highlights the importance of recognizing SSPE even in young adults.
  • Intrathecal interferon-α (IFN-α) combined with oral isoprinosine represents a potential therapeutic strategy.
  • Further research into effective treatments for SSPE is crucial to improve patient outcomes.
Keywords:
brain mri flair signalsgeneralized tonic-clonic seizuresintrathecal interferon-α (ifn-α)measles antibody titersubacute sclerosing panencephalitis (sspe)

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