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Neurology
Subacute sclerosing panencephalitis presenting as severe depression in an adult
  1. Vijayakumar Karthik1,
  2. Kiren George Koshy2,
  3. Arsha Asok3 and
  4. Selvarajan Chettiar3
  1. 1 Endocrinology, Government Medical College Thiruvananthapuram, Thiruvananthapuram, India
  2. 2 Government Medical College and Hospital, Thiruvananthapuram, Kerala, India
  3. 3 Government Medical College and Hospital, Trivandrum, Kerala, India
  1. Correspondence to Dr Vijayakumar Karthik; kannanhbk91{at}gmail.com

Abstract

Subacute sclerosing panencephalitis (SSPE) is a fatal disorder that occurs as a rare complication of childhood measles. Symptoms typically manifest between the ages of 5 and 15. While the incidence of SSPE is declining globally, it is still prevalent in regions where measles remains common and vaccination rates are low due to poverty and lack of health education. Diagnosing SSPE can be challenging, particularly when patients exhibit unusual symptoms. A thorough clinical evaluation, including vaccination history, physical examination, electroencephalogram (EEG) and Cerebrospinal fluid (CSF) analysis, can help in making a diagnosis. We present the case of a young woman in her early 20s who initially experienced depressive symptoms, followed by myoclonus, dementia and visual impairment. The patient was ultimately diagnosed with SSPE based on characteristic EEG findings, neuroimaging results, CSF analysis and elevated serum measles antibody levels.

  • Psychiatry
  • Neurology

https://doi.org/10.1136/bcr-2023-259111

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    Footnotes

    • Contributors The following authors were responsible for drafting of the text, sourcing and editing of clinical images, investigation results, drawing original diagrams and algorithms, and critical revision for important intellectual content: VK, KGK, SC, AA. The following authors gave final approval of the manuscript: VK, KGK, SC, AA.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.