Chronic progressive panencephalitis due to rubella virus simulating subacute sclerosing panencephalitis

Area of Science:

• Neurology
• Virology
• Pediatrics

Background:

• Congenital rubella syndrome (CRS) is a rare condition caused by maternal rubella infection during pregnancy.
• CRS can lead to various long-term complications, including neurological deficits.

Purpose of the Study:

• To investigate a case of late-onset chronic progressive panencephalitis in a patient with CRS.
• To identify the causative agent of the panencephalitis.

Main Methods:

• Clinical case study of a 12-year-old boy with CRS.
• Neurological examination, cerebrospinal fluid analysis, electroencephalography (EEG).
• Serological testing for rubella and measles antibodies, viral isolation from brain tissue.

Main Results:

• The patient presented with progressive dementia, ataxia, choreiform movements, myoclonic seizures, and visual disturbances.
• Cerebrospinal fluid showed elevated protein and gamma globulin.
• EEG revealed generalized slowing.
• High antibody titers for rubella virus were detected in serum and CSF.
• Brain biopsy showed panencephalitis with perivascular deposits, and rubella virus was isolated.

Conclusions:

• This case highlights a rare neurological complication of CRS, characterized by late-onset panencephalitis.
• Rubella virus is implicated as the causative agent in this form of panencephalitis.
• The findings contribute to understanding the long-term neurological sequelae of congenital rubella infection.