Subacute Sclerosing Panencephalitis Mimicking Posterior Circulation Ischemic Stroke

Abstract

Abstract Subacute sclerosing panencephalitis (SSPE) is a progressive neurodegenerative disease that develops 2–10 years after a measles infection. The diagnosis is possible through history, electroencephalography findings, and measles antibodies in the cerebrospinal fluid. Magnetic resonance imaging (MRI) is also an assistive tool in the diagnosis. The typical presentation of the disease on MRI is the bilateral, asymmetric lesions in the periventricular and subcortical areas. Brainstem involvement is uncommon. We describe a 12-year-old boy who was initially diagnosed with posterior circulation ischemic stroke with left cerebellar peduncle diffusion restriction, treated with low molecular weight heparin, and later found to have SSPE. His follow-up MRI in 2 months showed massive cerebral cortical and white matter destruction although his first MRI with cerebellar peduncle diffusion restriction initially revealed almost normal cerebral cortex and white matter. Brainstem involvement with diffusion restriction helps expand the radiological spectrum of SSPE.