CASE REPORT
Interesting MRI finding in SSPE – a case report
 
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1
Vydehi Institute of Medical Sciences & Research Centre, Bengaluru, India
2
Columbia Asia Referral Hospital, Bangalore, India
CORRESPONDING AUTHOR
Krishna Prasad Kurpad   

No 579, 6th Cross, Laggere, Bangalore 560 058, India.
Online publication date: 2019-11-24
Submission date: 2018-05-30
Final revision date: 2019-06-17
Acceptance date: 2019-06-26
 
Pol. Ann. Med. 2020;27(1):45–47
KEYWORDS
TOPICS
ABSTRACT
Introduction:
10% of the subacute sclerosing panencephalitis (SSPE) presents with atypical features.

Aim:
SSPE is rare chronic encephalitis caused by persistent infection with defective measles virus. Characteristic MRI findings include signal changes (T2W and FLAIR hyperintensities) in bilateral occipital and parietal regions involving both gray and white matter. Early involvement of cerebellum and brainstem is not common.

Case study:
A 17-year-old male presented with complaints of recurrent seizures, slow walking, and behavioral abnormality. Neurological examination revealed cogwheel rigidity in all four limbs. MRI of the brain revealed asymmetrical cortical and subcortical altered signal intensities (T2W and FLAIR hyperintensity and T1W hypointensity) involving temporal and occipital lobes bilaterally (left more than right) with diffuse atrophy of cerebrum and cerebellum.

Results and discussion:
Early onset extrapyramidal features, seizures without myoclonus with MRI finding of posterior predominant asymmetrical cortical and subcortical signal abnormality is uncommon in SSPE.

Conclusions:
A high index of clinical suspicion for SSPE has to be maintained in patients haling from endemic areas, unvaccinated individuals presenting with seizures, behavioral abnormality, and extrapyramidal features.

ACKNOWLEDGEMENTS
We thank our colleagues from Vydehi Institute of Medical Sciences and Research Center who provided insight and expertise that greatly assisted the research, although they may not agree with all of the interpretations/conclusions of this paper.
CONFLICT OF INTEREST
We hereby declare that there is no conflict of interest.
FUNDING
This research was not funded.
 
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