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Adult-onset subacute sclerosing panencephalitis
  1. Sruthi S Nair,
  2. K V Vysakha,
  3. Ramshekhar N Menon,
  4. Soumya Sundaram
  1. Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, India
  1. Correspondence to Dr Soumya Sundaram, Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram 695011, India; ssdr.soumya{at}gmail.com

Abstract

Subacute sclerosing panencephalitis (SSPE) is a lethal slow viral disease of the central nervous system caused by a defective measles virus. The onset is mostly in childhood, manifesting clinically as decline in academic performance, behavioural changes, motor dysfunction and myoclonus. Adult-onset SSPE is rare and can present as rapidly progressive dementia. We present a young man of Indian origin with adult-onset SSPE with rapidly progressive dementia but no localising neurological signs. The diagnostic clues were parieto-occipital white matter changes on MR brain scan and history of childhood fever with rash. High titres of antimeasles antibody in cerebrospinal fluid confirmed the diagnosis. The long latency from primary measles virus infection to symptom onset can be misleading in adults. SSPE should be considered in adults with dementia, especially in tropical countries where vaccination coverage is suboptimal.

  • dementia
  • infectious diseases
  • MRI
  • myoclonus

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Footnotes

  • Contributors SSN did the study design, acquisition of data, drafting and final approval of manuscript. KVV was involved in diagnostic evaluation and management of the patient, acquisition and interpretation of data, and critical revision of manuscript. RNM was involved in critical revision and final approval of the manuscript. SS helped in study concept, design, drafting, critical revision and final approval of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed by Jason Warren, London, UK.

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