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Subacute Sclerosing Panencephalitis in a North African Cohort: Findings From the Post-Measles Epidemic Era

Meriem Ben Hafsa1,2, Zouhour Miladi1,2, Insaf Dkhil2,3

  • 1Department of Child and Adolescent Neurology, Research Laboratory LR18SP04, National Institute Mongi Ben Hmida of Neurology, La Rabta, Tunis, Tunisia.

Sage Open Pediatrics
|July 4, 2025
PubMed

Insights

Subacute sclerosing panencephalitis (SSPE), a fatal measles virus encephalitis, is resurging in children. This study highlights its clinical signs, brain imaging findings, and poor prognosis, urging prompt diagnosis.

Area of Science:

  • Neurology
  • Virology
  • Pediatrics

Background:

  • Subacute sclerosing panencephalitis (SSPE) is a rare, fatal neurological complication of chronic measles virus infection.
  • Recent measles epidemics have led to a resurgence of SSPE, particularly in pediatric populations, necessitating increased clinical awareness.

Purpose of the Study:

  • To describe the clinical presentation, diagnostic features, treatment outcomes, and prognosis of SSPE in a cohort of 15 pediatric patients.
  • To enhance recognition of SSPE among clinicians and radiologists, especially in the context of recent measles outbreaks.

Main Methods:

  • Retrospective analysis of clinical data, neurological examinations, electroencephalograms (EEGs), and brain imaging (MRI) from 15 SSPE patients.
  • Laboratory confirmation included testing for anti-measles immunoglobulin G (IgG) in cerebrospinal fluid (CSF) and serum.

Main Results:

  • Patients presented with gait disturbances, psychomotor regression, and behavioral changes, progressing to cognitive decline, visual impairment, and movement disorders.
  • EEG revealed periodic delta wave complexes; MRI showed white matter lesions, brainstem involvement, and progressive atrophy.
  • All patients had elevated anti-measles IgG in CSF and blood, and despite treatment, showed rapid deterioration to akinetic mutism.

Conclusions:

  • SSPE should be considered in children with subacute cognitive decline, myoclonus, epilepsy, and characteristic white matter changes, particularly following measles epidemics.
  • Early recognition and diagnosis are crucial, although the prognosis remains poor, emphasizing the importance of measles vaccination to prevent SSPE.
Keywords:
childrenencephalitisepilepsymeaslesmyoclonus- neuroimaging

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