Subacute Sclerosing Panencephalitis (SSPE): A Fatal Aftermath of Measles Infection

Abstract

Subacute Sclerosing Panencephalitis (SSPE) is a progressive form of encephalitis without a cure. This case report pertains to a primigravida diagnosed with SSPE in her fifth month of pregnancy. She has been married for two years. During her sixth month of pregnancy, she developed signs of SSPE such as behavioral and personality changes, social detachment, reduced involvement in household work which progressed to mutism, altered sensorium, involuntary movement of right half of face and myoclonic jerks involving right upper and lower limbs, in spite of that, she delivered a baby boy who within a month died due to diarrhea. The patient had several episodes of seizures which subsided with antiepileptic and antiviral drugs initially but on March 3, 2018 she again had myoclonic episodes of seizures, from which she did not recover. EEG findings showed periodic episodes of high-amplitude delta-frequency activity associated with the involuntary movements, superimposed on relatively normal background activity and elevated levels of gamma globulin and measles antibody in serum and cerebrospinal fluid was suggestive of SSPE. During pregnancy, marked by physiological immunosuppression, there is a greater chance of SSPE outbreak which requires constant care, follow up and observing initial manifestations of SSPE to delay the course of disease with symptomatic medications or treatment when the inflammatory changes are, possibly, still reversible. The long-term outlook for people with subacute sclerosing panencephalitis (SSPE) is poor. Since the condition is always fatal, the only way to prevent SSPE is to get the measles vaccination