Subacute sclerosing panencephalitis with parkinsonian features in a child: A case report.
BACKGROUND
Subacute sclerosing panencephalitis (SSPE) can present with atypical clinical signs which may result in delayed diagnosis and treatment. We present a child with SSPE whose initial manifestation was parkinsonism.


METHODS
This 12-year-old boy presented with the complaint of difficulty in standing up and walking for 2 months. Neurological examination revealed generalized rigidity, bradykinesia, impaired postural reflexes, and a mask-like facies. The initial diagnosis of Juvenile Parkinson Disease was made. He had no improvement with levodopa, trihexyphenidyl, tetrabenazine and clonazepam. The EEG showed irregular background activity with generalized slow waves which were not suppressed with diazepam injection. SSPE was considered and the diagnosis was confirmed with the identification of measles antibodies in cerebrospinal fluid.


CONCLUSIONS
SSPE should be considered in children and adolescents with parkinsonian symptoms, particularly in the absence of a history of vaccination against measles.
Department of Pediatrics, University of Mersin, Faculty of Medicine, Mersin, Turkey; Division of Pediatric Neurology, University of Mersin, Faculty of Medicine, Mersin, Turkey. Electronic address: gulnebi@hotmail.com.
Gulcin
G
Bozlu
Department of Pediatrics, University of Mersin, Faculty of Medicine, Mersin, Turkey; Division of Pediatric Neurology, University of Mersin, Faculty of Medicine, Mersin, Turkey.
Meltem
M
Cobanogullari Direk
Department of Pediatrics, University of Mersin, Faculty of Medicine, Mersin, Turkey; Division of Pediatric Neurology, University of Mersin, Faculty of Medicine, Mersin, Turkey.
Cetin
C
Okuyaz
D000906:Antibodies / Q000276:immunology; D001921:Brain / Q000473:pathology / Q000503:physiopathology; D002648:Child; D003951:Diagnostic Errors; D006801:Humans; D008297:Male; D008459:Measles virus / Q000276:immunology; D020734:Parkinsonian Disorders / Q000175:diagnosis*; D013344:Subacute Sclerosing Panencephalitis / Q000175:diagnosis* / Q000276:immunology / Q000473:pathology / Q000503:physiopathology
D000906:Antibodies
Atypical; Children; Parkinsonism; SSPE