Subacute sclerosing panencephalitis – variety of clinical presentations

Subacute sclerosing panencephalitis (SSPE) is a subacute inflammatory and degenerative disease of the entire brain. Onset of the disease is most often during childhood. In developed countries the disease is nowadays extremely rare, but with occasional outbursts of measles, sporadic cases appear. Epidemiology is different in undeveloped countries with low immunization rates for measles, and many affected children with high rates of mortality. Clinical presentation of the disease is most often characterized by the onset of behavioral and intellectual deterioration, involuntary movements and seizures, motor and sensory changes, as well as vegetative and systematic changes. They can appear years after an acute measles infection (usually up to 10 years, but sometimes more). Clinical presentation can be very variable, and erroneous diagnosis is not rare.Before the war, Bosnia and Herzegovina had high immunization rates and very rarely diagnosed patients with SSPE. During the war immunization rates dropped often to less than 20% and after the war we had a surge of children diagnosed with this disease. Clinical presentations varied and initial diagnosis was sometimes difficult. We are presenting patients for the last 10 years, and the variability of their symptoms. Initial symptoms and the course of SSPE are highly variable, and clinicians should have in mind the possibility of the disease in different neurological conditions.
Category: Clinical observations - professional paper
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