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Preliminary evidence of cardiac dysfunction in subacute sclerosing panencephalitis: a systematic review and
Nikhil Pandey1, Neetu Rani Dhiman1, Deepika Joshi1
1Department of Neurology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India.
Insights
Subacute sclerosing panencephalitis (SSPE) can cause cardiac arrhythmia due to measles virus effects on the nervous system. Studies indicate elevated heart rates in SSPE patients, highlighting the need for further research into cardiac dysfunction.
Area of Science:
- Neurology
- Cardiology
- Infectious Diseases
Background:
- Subacute sclerosing panencephalitis (SSPE) is a severe neurological disorder.
- Cardiac arrhythmia is an under-recognized complication of SSPE.
- Measles virus persistence in SSPE affects the central nervous system, impacting autonomic function and cardiac rhythm.
Purpose of the Study:
- To comprehensively review literature on cardiac dysfunction in SSPE.
- To analyze the association between SSPE and cardiac rhythm abnormalities.
Main Methods:
- Literature search conducted in PubMed, Scopus, ProQuest, Emerald, and Google Scholar databases.
- Articles published up to October 2025 were identified for review.
- A meta-analysis was performed on eligible studies.
Main Results:
- A total of 947 results were identified, with 4 articles meeting eligibility criteria.
- Meta-analysis of three studies showed significantly higher heart rates in SSPE patients (pooled mean difference of 11.20 bpm).
Conclusions:
- Preliminary evidence suggests cardiac autonomic disturbances, including elevated heart rates, occur in some SSPE patients.
- Further rigorous research is required to understand the prevalence, mechanisms, and clinical impact of cardiac dysfunction in SSPE.
Purpose:
Subacute sclerosing panencephalitis (SSPE) is a catastrophic neurological disorder that typically presents in infancy and early adolescence. Cardiac arrhythmia in SSPE is a significant but often under-recognized complication of the disease. The persistent measles virus infection that characterizes SSPE can have widespread effects on the central nervous system, including areas that regulate autonomic function, which in turn can impact cardiac rhythm. In this article, we aim to comprehensively review articles describing cardiac dysfunction associated with SSPE.
Methods:
We conducted a literature search in PubMed, Scopus, ProQuest, Emerald, and Google Scholar databases of articles published till October, 2025, identified items for review, and conducted a meta-analysis.
Results:
A total of 947 results were identified across five databases, with 378 studies initially screened, and 569 articles were excluded (10 duplicates and 559 unrelated to the study). Only 4 articles met the eligibility criteria. Our meta-analysis of the three studies showed a pooled mean difference of 11.20 beats per minute (95% confidence interval, 5.52-16.88), with case groups having significantly higher heart rates than controls.
Conclusion:
The few available studies provide preliminary evidence suggesting that cardiac autonomic disturbances, including elevated heart rates and reduced HRV, occur in a subset of patients with SSPE. More rigorously designed investigations are needed to clarify the prevalence, mechanisms, and clinical impact of cardiac dysfunction in SSPE.
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