title: Measles-vaccinated Israeli boy with subacute sclerosing panencephalitis.
abstract: Subacute sclerosing panencephalitis is a rare neurologic disorder of childhood and adolescence. We describe a 16-year-old boy who manifested the disease despite proper vaccinations. He was hospitalized because of bedwetting, involuntary limb movements, abnormal speech, and balance disturbances. Immunoglobulin G antibodies against measles were strongly positive, with a high relative cerebrospinal fluid/serum ratio. Polymerase chain reaction for measles produced negative results. Electroencephalography registered slow activity with high voltage discharges every few seconds, and with triphasic complex morphology. Magnetic resonance imaging revealed diffuse white matter changes, mostly around the posterior regions and lateral ventricles. Treatment with valproic acid, levetiracetam, carbamazepine, and intravenous immunoglobulin G was ineffective. Inosiplex and interferon-β-1a were also administrated. The patient became comatose, with generalized myoclonic jerks, and died 1 year later. An autopsy was not performed. This patient illustrates that subacute sclerosing panencephalitis should be suspected among young vaccinated subjects.
authors.affiliation: Department of Pediatrics, Assaf Harofeh Medical Center, Zerifin, and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Ronly
authors.initials: R
authors.lastname: Har-Even
authors.forename: Sergio
authors.initials: S
authors.lastname: Aichenbaum
authors.forename: Jose M
authors.initials: JM
authors.lastname: Rabey
authors.forename: Amir
authors.initials: A
authors.lastname: Livne
authors.forename: Tzvy
authors.initials: T
authors.lastname: Bistritzer
mesh_terms: D000293:Adolescent; D004569:Electroencephalography / Q000379:methods; D017809:Fatal Outcome; D006801:Humans; D007074:Immunoglobulin G / Q000096:biosynthesis; D007557:Israel; D008297:Male; D008458:Measles Vaccine / Q000276:immunology*; D008459:Measles virus / Q000276:immunology*; D013344:Subacute Sclerosing Panencephalitis / Q000175:diagnosis / Q000276:immunology* / Q000821:virology*
chemical_list: D007074:Immunoglobulin G; D008458:Measles Vaccine