Cluster of partial motor seizures heralding the onset of hemimyoclonic subacute sclerosing panencephalitis

Malhotra, Hardeep Singh; Garg, Ravindra Kumar; Naphade, Pravin

doi:10.1002/mds.24951

Cited by 8 publications

(6 citation statements)

References 14 publications

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“…10,11 Epilepsia partialis continua has also been described in SSPE, but these patients have generalized periodic EEG abnormalities. 12 The clinical features of fulminant SSPE are, frequently, atypical and can be misleading. Our case of fulminant SSPE mimicked the acute encephalitis syndrome.…”

Section: Discussionmentioning

confidence: 99%

Case Report: Subacute Sclerosing Panencephalitis Presenting as Acute Encephalitis

Garg

Kumar

Rizvi

et al. 2019

The American Journal of Tropical Medicine and Hygiene

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Subacute sclerosing panencephalitis (SSPE) is still a common disease in India which is characterized by a progressive mental decline, myoclonus, periodic encephalographic abnormalities, and raised anti-measles antibody titter in the cerebrospinal fluid. Acute fulminant SSPE is characterized by a rapid course of disease culminating in death, within 6 months. We report of a 10-year-old boy, who came with a 14-day history of continuous involuntary jerky movements of the left half of the body, including the head. There was a highly increased anti-measles IgG antibody titer, both in the cerebrospinal fluid and serum. We conclude that acute rapidly progressive SSPE can present as acute encephalitis syndrome.

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Section: Discussionmentioning

confidence: 99%

Case Report: Subacute Sclerosing Panencephalitis Presenting as Acute Encephalitis

Garg

Kumar

Rizvi

et al. 2019

The American Journal of Tropical Medicine and Hygiene

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“…Criteria to reliably establish a diagnose of SSPE have been proposed and include characteristic clinical features and EEG pattern, elevated immunoglobulin levels and measles virus antibodies in the CSF together with typical histopathology on brain biopsy or postmortem examination ( Table 1 ). 4 , 6 …”

Section: Discussionmentioning

confidence: 99%

“… 2 Diffusion-weighted imaging can be positive as result of membrane break-down. 6 , 10 , 11 In a study of 76 patients with SSPE, 3 of them had basal ganglia involvement at Stage III. 12 None of the neuroimaging abnormalities were associated with poor prognosis or clinical deterioration.…”

Section: Discussionmentioning

confidence: 99%

Basal ganglia lesions in subacute sclerosing panencephalitis

Almeida

Brucki

Duarte³

et al. 2012

Dement. neuropsychol.

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The parieto-occipital region of the brain is the most frequently and severely affected in subacute sclerosing panencephalitis (SSPE). The basal ganglia, cerebellum and corpus callosum are less commonly involved. We describe a patient with SSPE confirmed by neuropathology based on brain magnetic resonance imaging showing extensive basal ganglia involvement and no significant involvement of other cortical structures. Though rarely described in SSPE, clinicians should be aware of this involvement. SSPE should be kept in mind when changes in basal ganglia signal are seen on brain magnetic resonance imaging with or without involvement of other regions of the human brain to avoid erroneous etiological diagnosis of other pathologies causing rapidly progressive dementia.

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“…98 Myoclonus may be differentiated from "drop attacks," which have been reported as a presenting feature of SSPE as well, in the absence of a myoclonus correlate. 99 Epilepsia partialis continua (EPC) has been observed in either advanced 100 or fulminant disease, 101 preceded by focal myoclonic clusters. The presence of EPC potentially links to the cortical origin of myoclonus in SSPE.…”

Section: Sspe As An Autoimmune Encephalitis Mimicmentioning

confidence: 99%

Movement Disorders in Patients with Subacute Sclerosing Panencephalitis: A Systematic Review

Garg,

Patel,

Sankhla

et al. 2024

Movement Disord Clin Pract

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BackgroundSubacute sclerosing panencephalitis (SSPE) is a complication of measles, occurring after a latency of 4–10 years. It continues to occur in developing countries although resurgence is being reported from developed countries. Characteristic features include progressive neuropsychiatric issues, myoclonus, seizures, movement disorders and visual impairment. Electroencephalography (EEG) typically shows periodic generalized discharges, and elevated CSF anti‐measles antibodies are diagnostic. Movement disorders are being increasingly recognized as part of the clinical spectrum, and range from hyperkinetic (chorea, dystonia, tremor, tics) to hypokinetic (parkinsonism) disorders and ataxia.ObjectivesThis article aims to comprehensively review the spectrum of movement disorders associated with SSPE.MethodsA literature search was conducted in PubMed and EMBASE databases in December 2023 and articles were identified for review.ResultsMovement disorders reported in SSPE included hyperkinetic (chorea, dystonia, tremor and tics), hypokinetic (parkinsonism), ataxia and extraocular movement disorders. Myoclonus, a core clinical feature, was the most frequent “abnormal movement.” Movement disorders were observed in all clinical stages, and could also be a presenting feature, even sans myoclonus. Hyperkinetic movement disorders were more common than hypokinetic movement disorders. An evolution of movement disorders was observed, with ataxia, chorea and dystonia occurring earlier, and parkinsonism later in the disease. Neuroradiological correlates of movement disorders remained unclear.ConclusionA wide spectrum of movement disorders was observed throughout the clinical stages of SSPE. Most data were derived from case reports and small case series. Multicentric longitudinal studies are required to better delineate the spectrum and evolution of movement disorders in SSPE.

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Cluster of partial motor seizures heralding the onset of hemimyoclonic subacute sclerosing panencephalitis

Cited by 8 publications

References 14 publications

Case Report: Subacute Sclerosing Panencephalitis Presenting as Acute Encephalitis

Case Report: Subacute Sclerosing Panencephalitis Presenting as Acute Encephalitis

Basal ganglia lesions in subacute sclerosing panencephalitis

Movement Disorders in Patients with Subacute Sclerosing Panencephalitis: A Systematic Review

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