title: Subacute sclerosing panencephalitis presenting as acute disseminated encephalomyelitis and pseudotumour cerebri.
abstract: Subacute sclerosing panencephalitis (SSPE) is a chronic progressive encephalitis of childhood and young adults due to persistent measles virus infection. The usual age of onset is between 5 and 15 years. There are wide varieties of presentations of SSPE described in the literatures. Variable clinical presentations may lead to diagnostic dilemma and unnecessary investigations especially in developing countries, where the measles is quite endemic and vaccination status is not up to the mark because of poor literacy and socioeconomic status. Good clinical correlations, neuroimaging findings, EEG and cerebrospinal fluid (CSF) marker for SSPE yield the clue to diagnosis. This case illustrates a 13-year-old boy presented with short history of intellectual decline, headache, papilloedema, cranial nerve palsy, myoclonus with suggestive neuroimaging mimicking acute disseminated encephalomyelitis (ADEM) and pseudotumour cerebri. Subsequently he was diagnosed to be a case of SSPE on the basis of CSF and serum measles antibody titer.
authors: Department of Neurology, Institute of Human Behaviour & Allied Sciences IHBAS, Delhi, India. drakhilapanda@gmail.com
authors: Akhila Kumar
authors: AK
authors: Panda
authors: Vachan Jayant
authors: VJ
authors: Mehta
authors: Siddharth
authors: S
authors: Maheshwari
authors: Sujit Kumar
authors: SK
authors: Kar
mesh_terms: D000293:Adolescent; D000914:Antibodies, Viral / Q000097:blood / Q000134:cerebrospinal fluid; D004569:Electroencephalography; D004673:Encephalomyelitis, Acute Disseminated / Q000175:diagnosis* / Q000209:etiology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D011559:Pseudotumor Cerebri / Q000175:diagnosis* / Q000209:etiology*; D013344:Subacute Sclerosing Panencephalitis / Q000150:complications*
chemical_list: D000914:Antibodies, Viral
references: Pediatr Neurol. 2009 May;40(5):371-6
references: 19380074
references: Neurology. 2002 Oct 22;59(8):1224-31
references: 12391351
references: Brain. 1950 Jun;73(2):141-66
references: 14791785
references: Clin Neurophysiol. 2007 Sep;118(9):1947-54
references: 17652019
references: Pediatr Neurol. 1998 May;18(5):439-41
references: 9650688
references: Indian J Pediatr. 2006 Dec;73(12):1119-21
references: 17202644
references: Am J Pathol. 1933 Jan;9(1):7-16.3
references: 19970059
references: Brain Dev. 2007 Aug;29(7):409-12
references: 17258414
references: J Neurol Neurosurg Psychiatry. 1984 Feb;47(2):176-83
references: 6707657
references: Acta Paediatr. 1998 Dec;87(12):1310-1
references: 9894837
references: Brain Dev. 2006 Jul;28(6):395-7
references: 16504441
references: J Child Neurol. 2009 Jul;24(7):899-903
references: 19204320
references: Brain. 1990 Apr;113 ( Pt 2):291-302
references: 2328406