
Navanita Sarma
Silchar Medical College and Hospital, IndiaPresentation Title:
A case study report on subacute sclerosing panencephalitis from an Indian tertiary care system
Abstract
Background: SSPE is a rare, slow progressive degeneration of CNS caused by a persistent measles virus infection. The latent period between measles infection and SSPE is commonly 6-8 years. It has a gradual progressive course leading to eventually death. According to Dyken’s criteria diagnosis can be established if any of the following five criteria fulfilled-
1)Typical clinical presentation with progressive intellectual deterioration with myoclonus signs. 2) characteristic EEG pattern 3) elevated CSF globulin levels. 4) elevated measles antibody titres in serum and/or CSF. 5) Brain biopsy suggestive of measles.
Case Proper: A 12-year-old girl, a student of class VII, hailing from Karimganj, Assam, presented with memory loss, intellectual deterioration and unexplained sudden decline in her scholastic performance since last 3 months. It was associated with decreased interaction and decreased intake of food and withdrawn and confused behaviour and persistent stereotyped movements. She also developed progressive weakness over the left side of her body and drooping of the head within a span of few days and developed an unsteady gait associated with difficulty in holding objects with hands with left-right disorientation. On 4th day of admission, she had 2 episodes of urinary incontinence. The case was finally diagnosed with the help of EEG, MRI BRAIN and characteristic CSF findings.
Discussion and Conclusion: SSPE can be very difficult to diagnose because it is rare and under or misdiagnosed. Through our case it can be learnt that mere absence of measles history or normal CT SCAN Brain cannot rule out the diagnosis. Its through proper and detailed history and thorough examination and finally necessary investigations with EEG, MRI Brain and CSF Analysis we can eventually reach upto diagnosis. As the disease can mimic acute encephalopathy, therefore we should include SSPE on the list of differential diagnosis of acute encephalopathy.
Biography
Navanita Sarma is a final year postgraduate trainee in the Department of Psychiatry, Silchar Medical College and Hospital. She has been awarded First in the Poster Presentation for the poster titled – “A difficult to diagnose case of SSPE with atypical presentation” at Annual Conference, IPS, Assam state branch, 2023 and has presented a paper titled – “Evaluation of Factors determining Functional Remission in patients with Schizophrenia” at Annual Conference, IPS, Assam state branch, 2024. She has published one paper in the renowned journal - Eastern Journal of Psychiatry.