Bilateral retinitis as the initial presentation of subacute sclerosing panencephilitis

Abstract

Subacute sclerosing panencephalitis (SSPE) is a ravaging disease of the central nervous system caused by persistent mutant measles virus. The diagnosis of SSPE is based on characteristic clinical and EEG findings and demonstration of elevated antibody titres against measles in cerebrospinal fluid. SSPE may have atypical clinical features at the onset. Herein, we report an atypical case of SSPE in an adolescent with bilateral retinitis as the initial presenting feature. The disease progressed with an appearance of cognitive worsening, myoclonic jerks, periodic high amplitude generalized complexes on EEG, and elevated titers of measles antibodies in cerebrospinal fluid leading to the final diagnosis of SSPE. The case warrants a high degree of suspicion on ophthalmologist’s part to clinch the definitive diagnosis of not so common deadly disease.