Subacute sclerosing pan encephalitis with HIV: two rare case reports

Abstract

Case Reports Two children, a 10 year old boy and an 11 year old girl, both HIV-1 seropositive following perinatally acquired infection, presented with strikingly different clinical symptoms to Neurology OPD, NIMHANS. The boy presented with deterioration in scholastic performance over a four month duration with generalized tonic clonic seizures of 1 month duration. Vision was normal. The girl was found to have evidence of bilateral blindness, altered gait with dysarthric speech and severe truncal ataxia. Both children were unvaccinated for measles and gave a definitive history of Measles at the age of 8 months and 6 years. The latent period between Measles infection and SSPE was 9 and 5 years respectively. Clinically both were staged at Jabbour Stage II and Gascon stage III. The CD4 counts were 554/mm and 130//mm respectively. In both patients, progressive cognitive decline, reduction in scholastic performance, regression of milestones and inability to walk with loss of self care occurred in 12 and 4 weeks respectively following onset.