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Published 2 March 2009
Cite this as: BMJ Case Reports 2009 [doi:10.1136/bcr.09.2008.0922]
Copyright © 2009 by the BMJ Publishing Group Ltd.

Rare disease

Fulminant adult-onset subacute sclerosing panencephalitis

Anthony Faivre1, Jean-Baptiste Souraud2, Aileen McGonigal3, Philippe Alla1, Jacques Grapperon1, Jacques Valance1

1 HIA Sainte-Anne, Service de Neurologie, Boulevard St-Anne, Toulon, 83000, France
2 HIA Sainte-Anne, Service d’Anatomopathologie, Boulevard St-Anne, Toulon, 83000, France
3 Assistance Publique Hôpitaux de Marseille, Hôpital la Timone, Service de Neurophysiologie Clinique, 264 Boulevard St-Pierre, Marseille, 13385, France

Correspondence to:
anthonyfa{at}wanadoo.fr

SUMMARY

We present the case of a young adult who developed acute encephalopathy with severe status epilepticus and rapid deterioration to a vegetative state and death within 6 weeks. Although the clinical picture, MRI and EEG findings were atypical, the hypothesis of subacute sclerosing panencephalitis (SSPE) was suggested by markedly increased intrathecal IgG synthesis in the cerebrospinal fluid (CSF) and diagnosis was confirmed by high antimeasles-antibodies in CSF and brain biopsy findings. Acute SSPE is an exceptionally rare and little-known form of SSPE with protean symptomatology and to our knowledge this case is the first observation of SSPE presenting with status epilepticus in an adult. Our case reiterates the need to include, even in developed countries, SSPE as a diagnostic possibility in unexplained acute encephalopathies.


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