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title:Case Report of Atypical presentation of SSPE with ADEM

Author:Nirali J Mehta, Binita M Surti, Deepak B Gamit, Maulik P Saliya

Keywords:Sub-acutesclerosing panencephalitis, EEG, ADEM

Type:Case report

Abstract:Sub-acutesclerosing panencephalitis (SSPE) is chronic encephalitis of childhood and young adolescents due to persistent measles virus infection of the central nervous system. In majority of cases, onset occurs from 5-15yrs of age. In a non-immunise population, the average onset is 8yrs.SSPE generally occurs 5-10years after measles infection. In the early stage of the disease, behaviour and personality changes is followed by myoclonic jerks and convulsion. In late stages dementia, stupor and coma develops. Diagnosis is achieved by typical clinical finding, increase measles antibody titre in cerebrospinal fluid and serum, high amplitude slow sharp waves in EEG. Prognosis is poor and death ensues in about 3 yrs. after the diagnosis.Atypical form of SSPE occurs in about 10% of patients and a high index of suspicion is needed to detect these atypical cases. We report a patient of SSPE who presented to us as ADEM. Effectiveimmunisation against measles is the only solutionpresently available to the problem of this dreadeddisease.

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