Abstract

A report is given on 10 children with subacute sclerosing panencephalitis (SSPE) whose clinical illness began with visual or mental impairment. All patients showed typical clinical and neurologic features and various ophthalmological manifestations. The latter correspond to lesions generally dealt with in a number of reports and demonstrate for the individual case that ophthalmological manifestation can precede clinical manifestation. The ophthalmologist can give an important contribution to the diagnosis. In some cases the focal retinal lesions can be similar to retinal lesions in the case of toxoplasmosis. A positive antibody titer for toxoplasmosis, which can occur parallel with the typical measles or SSPE virus antibody titer, occasionally causes the misdiagnosis of toxoplasmosis acquisita. In the 10 cases reported on, the diagnosis SSPE was confirmed on the basis of the typical clinical features and elevated measles virus antibody titer. In no case the permission for autopsy was gained. The genesis of SSPE is discussed with reference to a genetic defect, to an autoimmune reaction, or as a result of a measles virus-like infection. In the diagnosis, primarily unclear 'focal retinal lesions' should be at any rate investigated with respect to measles or SSPE virus antibody titer.

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