A Clinical Exploration of SSPE in Adolescents : A Case Series

Abstract

Subacute Sclerosing Panencephalitis (SSPE) is a rare but devastating slowly progressive neurological disorder that typically occurs 6 to 10 years following an initial measles virus infection. SSPE remains a critical concern in the context of historical measles infections, particularly in unvaccinated populations. This case-based review focuses on the clinical features and diagnostic challenges for SSPE. Here, we demonstrate two cases that highlight the variability in presentation and progression of the disease.

The distinctive feature of SSPE is the gradual deterioration of neurological function, with progressive cognitive impairment, seizure and motor dysfunction leading to severe disability. But the clinical presentation of SSPE can often be subtle, and initial symptoms may be mistaken for other developmental disorders that leading to diagnostic difficulty. Thus, a high index of suspicion is essential. The combination of clinical features, EEG findings, and CSF analysis can provide a comprehensive approach to diagnosis. Enhanced EEG techniques and CSF analysis have been emphasized for early detection, with several studies showing that early intervention can lead to better outcomes. Atypical presentation of SSPE must be recognized in area with high incidence. EEG findings were found to be the most important indicator for diagnosis.

The review emphasizes the importance of early recognition and diagnosis to manage the progression of SSPE. While there is currently no curative treatment, symptomatic management and supportive care can improve quality of life for affected individuals. Increased awareness among clinicians regarding the late sequelae of measles virus infection is important for timely diagnosis and intervention. Ongoing research is needed to refine diagnostic methodologies and explore potential therapeutic modalities.

J Dhaka Med Coll. 2023; 32(2) : 139-144