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VARIATIONS IN CLINICAL PRESENTATION, NEUROIMAGING AND ELECTROENCEPHALOGRAPHIC PATTERNS OF SUBACUTE SCLEROSING PANENCEPHALITIS

Objective: To determine the variations in clinical presentation, neuroimaging and electroencephalographic patterns of subacute sclerosing panencephalitis. Study Design: Cross sectional study. Place and Duration of Study: The Children’s Hospital & Institute of Child Health, Lahore, Pakistan from July 2020 to December 2020. Methodology: This study was conducted on children presented with clinical features suggestive of subacute sclerosing panencephalitis, along with positive anti-measles antibodies on cerebrospinal fluid. Association between variables was determined to formulate early diagnosis of subacute sclerosing panencephalitis Results: Out of 47 children, 29 were males with mean age of 6.54 ± 2.9 years. Only 23% were fully immunized against measles, 36.2% were unvaccinated and 40.4% received partial immunization. Mean age of measles infection was 1.49 ± 1.2years; mean interval between measles and onset of SSPE was 4.13 ± 3.0 year. Atypical clinical presentation was seen in 38.3% with intractable epilepsy (8.5%), focal deficit (8.5%) and extrapyramidal symptoms (8.5%) being commonest followed by coma (6.4%), visual loss (4.3%) and psychosis (2.1%). Neuroimaging was suggestive of cortical hyperintensities in 46.8% and was normal in 46.8%. Electroencephalography showed burst suppression in 55.3% and atypical findings in 19.1%. Younger age (1-1.5 years) of measles and unimmunized status were associated with early onset of SSPE with p-value of 0.001 and 0.05 respectively. Non immunized status was associated with atypical presentation of SSPE (p-value<0.05). Conclusion: The younger age of measles infection and failure to receive complete immunization led to early onset of SSPE with an atypical presentation.
Keywords: Anti-measles Antibodies, Electroencephalography, Subacute Sclerosing Panencephalitis

Areeba Wasim
University of Child Health Sciences and Children's Hospital Lahore Pakistan
Pakistan

Tipu Sultan
University of Child Health Sciences and Children's Hospital Lahore Pakistan
Pakistan

Zia Ur Rehman Rehman
University of Child Health Sciences and Children's Hospital Lahore Pakistan
Pakistan

 

 


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