Comparative study of the outcome of pediatric subacute sclerosing pan-encephalitis patients treated with oral ribavirin versus intraventricular interferon alpha 2b via Ommaya reservoir

Abstract

Introduction: Subacute sclerosing pan-encephalitis is a childhood disease occurring after a latent period of 2–12 years due to persistent defective measles virus within the neurons and glial cells. Various drugs have been used in treating SSPE with mixed success. Methods: All patients diagnosed with SSPE at the Neurology department from January 2011 to March 2018 were included in the study. Initially (upto January 2015) all patients of SSPE were treated with oral ribavirin (Group 1, N=8). There after, when we received the Government supply of interferon alpha 2b, we shifted to its intraventricular administration via Ommaya reservoir (Group 2, N=9). The data was retrospectively collected from the medical records of the patients. Results: No statistically significant difference existed in the baseline parameters of the patients of the two groups. Patients of Group 2 had significantly better outcome in terms of reduction in Jabbour staging, cerebrospinal fluid measles antibody titre and Brief Assessment Examination scores. Lower age, lower latent period between measles infection and onset of clinical features of SSPE and higher Jabbour staging predicted the poor outcome in the univariate analysis. Conclusion: Intraventricular interferon alpha therapy is far superior to oral ribavirin. However, all studies with interferon alpha did not report significantly favorable outcome, thereby, necessitating further multicentric studies with larger sample sizes.