Neuropediatrics 2009; 40(4): 195-198
DOI: 10.1055/s-0029-1243174
Short Communication

© Georg Thieme Verlag KG Stuttgart · New York

Atypical Presentations of Subacute Sclerosing Panencephalitis in Two Neurologically Handicapped Cases

E. Demir1 , A. Ozcelik1 , E. Arhan1 , A. Serdaroglu1 , K. Gucuyener1
  • 1Gazi University, School of Medicine, Department of Child Neurology, Ankara, Turkey
Further Information

Publication History

received 21.07.2009

accepted 15.10.2009

Publication Date:
04 February 2010 (online)

Abstract

Subacute sclerosing panencephalitis (SSPE) is a neurodegenerative disorder caused by persistent measles infection. Here, we report two neurologically handicapped cases presenting with atypical features of SSPE. Patient 1 who had mild mental retardation manifested acute encephalopathy with partial seizures and hemiplegia, mimicking encephalitis. He showed a fulminant course without myoclonia or a periodic electroencephalogram complex. Although SSPE is usually associated with an increased diffusion pattern, diffusion-weighted imaging of our patient showed decreased diffusion in the right hippocampus. Patient 2 with infantile hemiparesis presented with secondary generalized seizures, followed by asymettrical myoclonias involving the side contralateral to the hemiparesis. A periodic electroencephalogram complex was absent on the previously damaged brain regions. Our findings show that preexisting neurological disorders may modify the clinical or electrophysiological findings of SSPE, leading to atypical presentations. SSPE should be considered in the differential diagnosis of acute encephalopathy with lateralizing signs or unidentified seizures. Decreased diffusion resolution in diffusion-weighted-imaging may correlate with rapid clinical progression in SSPE.

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Correspondence

Dr. Ercan Demir

Gazi Universitesi Tıp Fakultesi

Gazi Hastanesi

Cocuk Sagligi ve Hastaliklari

ABD

Ankara

Turkey

Phone: +90/312/202 60 06

Fax: +90/312/215 01 43

Email: ercdemir28@yahoo.com

Email: ercdemir@tr.net