Subacute sclerosing panencephalitis (patient information)

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 * Associate Editor(s)-In-Chief: Varun Kumar, M.B.B.S.

Overview
Subacute sclerosing panencephalitis (SSPE) is a progressive, debilitating, and deadly brain disorder related to measles (rubeola) infection.

What are the symptoms of Subacute sclerosing panencephalitis?

 * Bizarre behavior
 * Dementia (loss of cognitive (thought), emotional, and social abilities)
 * Coma
 * Gradual behavioral changes
 * Myoclonic jerking (quick muscle jerking or spasms)
 * School problems
 * Seizures
 * Unsteady gait
 * Very tense muscles or muscles that lack tone, with weakness in both legs

What causes Subacute sclerosing panencephalitis?
Ordinarily, the measles virus does not cause brain damage, but an abnormal immune response to measles or, possibly, certain mutant forms of the virus may cause severe illness and death. This leads to brain inflammation (swelling and irritation) that may last for years.

SSPE has been reported in all parts of the world, but in western countries it is considered a rare disease.

Fewer than 10 cases per year are reported in the United States, a dramatic decrease that followed the nationwide measles immunization program. However, in some countries like India, over 20 cases of SSPE per million people are reported each year.

Who is at highest risk?
SSPE tends to occur several years after an individual has measles, even though the person seems to have fully recovered from the illness. Males are more often affected than females, and the disease generally occurs in children and adolescents

When to seek urgent medical care?
Call your health care provider if your child has not completed their scheduled vaccines. The measles vaccine is included in the MMR vaccine.

Diagnosis
There may be a history of measles in an unvaccinated child. A physical examination may reveal:


 * Damage to the optic nerve, which is responsible for sight
 * Damage to the retina, the part of the eye that receives light
 * Muscle twitching
 * Poor performance on motor (movement) coordination tests

The following tests may be performed:


 * Electroencephalogram (EEG)
 * Brain MRI
 * Serum antibody titer to look for signs of previous measles infection
 * Spinal tap

Treatment options
No cure for SSPE exists. However, certain antiviral drugs may slow the progression of the disease.

Where to find medical care for Subacute sclerosing panencephalitis?
Directions to Hospitals Treating Subacute sclerosing panencephalitis

What to expect (Outlook/Prognosis)?
Persons with this disease frequently die 1 to 2 years after diagnosis, but some may survive for longer periods. The condition is always deadly.

Possible complications
Prior to death, there may be:


 * Behavior changes
 * Dementia
 * Stupor and coma
 * Seizures and subsequent injuries

Prevention
Immunization against measles is the only known prevention for SSPE. The measles vaccine has been highly effective in reducing the numbers of affected children.

Measles immunization should be done according to the recommended American Academy of Pediatrics and Centers for Disease Control schedule.