Primary Psychiatric Manifestations of Subacute Sclerosing Panencephalitis: A Case Report and Literature Review

Reddy, Balaswamy; Das, Soumitra; Guruprasad, Srinivas

doi:10.1016/j.psym.2017.12.004

Cited by 9 publications

(7 citation statements)

References 17 publications

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“…Diagnostic confusion is frequently encountered in early stages or in countries where there is less familiarity with SSPE (Table ). In many cases, there are primary psychiatric manifestations, like schizophrenia, and patients are treated by a psychiatrist . Many children are considered to have malingering or conversion reaction.…”

Section: Differential Diagnosismentioning

confidence: 99%

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Subacute sclerosing panencephalitis

Garg

Mahadevan

Malhotra

et al. 2019

Reviews in Medical Virology

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Summary Subacute sclerosing panencephalitis (SSPE) is a slowly progressive brain disorder caused by mutant measles virus. SSPE affects younger age groups. SSPE incidence is proportional to that of measles. High‐income countries have seen substantial decline in SSPE incidence following universal vaccination against measles. SSPE virus differs from wild measles virus. Measles virus genome recovered from the autopsied brain tissues demonstrates clustered mutations in virus genome particularly in the M gene. These mutations destroy the structure and functioning of the encoded proteins. Complete infectious virus particle has rarely been recovered from the brain. Human neurons lack required receptor for entry of measles virus inside the neurons. Recent in vitro studies suggest that mutations in F protein confer hyperfusogenic properties to measles virus facilitating transneuronal viral spread. The inflammatory response in the brain leads to extensive tissue damage. Clinically, SSPE is characterized by florid panencephalitis. Clinically, SSPE is characterized by cognitive decline, periodic myoclonus, gait abnormalities, vision loss, and ultimately to a vegetative state. Chorioretinitis is a common ocular abnormality. Electroencephalography (EEG) shows characteristic periodic discharges. Neuroimaging demonstrates periventricular white matter signal abnormalities. In advanced stages, there is marked cerebral atrophy. Definitive diagnosis requires demonstration of elevated measles antibody titers in cerebrospinal fluid (CSF). Many drugs have been used to stabilize the course of the disease but without evidence from randomized clinical trials. Six percent of patients may experience prolonged spontaneous remission. Fusion inhibitor peptide may, in the future, be exploited to treat SSPE. A universal vaccination against measles is the only proven way to tackle this menace currently.

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Section: Differential Diagnosismentioning

confidence: 99%

“…In many cases, there are primary psychiatric manifestations, like schizophrenia, and patients are treated by a psychiatrist. 104 Many children are considered to have malingering or conversion reaction.…”

Section: Neuroimagingmentioning

confidence: 99%

Subacute sclerosing panencephalitis

Garg

Mahadevan

Malhotra

et al. 2019

Reviews in Medical Virology

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“…There have been very few case reports from India where catatonic symptoms, schizophrenic symptoms, depressive symptoms and mood lability have been reported in the initial phase of the illness [7][8][9][10][11][12]. This case highlights the need to keep a differential of viral encephalitis, especially when a child presents with catatonia along with myoclonus.…”

Section: Discussionmentioning

confidence: 99%

Case of Subacute Sclerosing Pan-Encephalitis (SSPE) presenting as catatonic schizophrenia

Chakraborty¹,

Chatterjee²,

Bhattacharyya³

et al. 2021

Journal of Indian Association for Child and Adolescent Mental H

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“…Although personality and behavioral changes are common early in the course of SSPE but pure psychiatric disorder as an early manifestation of this fatal neurological disorder has been rare [2,3]. We hereby describe a case of 8 year old boy, who presented with depression and developed symptoms of mania on antidepressant but eventually developed the typical symptoms of SSPE highlighting the importance of keeping in mind the differential diagnosis of organic causes for childhood depression and mania [3][4][5][6][7][8][9][10]. Our case is unique in that it was a rare case of antidepressant induced mania eventually turning out to be a case of SSPE.…”

Section: Introductionmentioning

confidence: 93%

Sub-Acute Sclerosing Panencephalitis Presenting as Anti-Depressant Induced Childhood Mania

Bhat¹,

Dar²,

Hussain³

2018

J Psychiatry

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Subacute sclerosing panencephalitis (SSPE) is a rare, predominantly childhood onset neurological illness that probably results from a latent or mutant measles virus infection of neurons with slowly progressive disease resulting in severe neurological deficit and death. In literature there have been reports of pure psychiatric symptoms as presenting complaints in patients with SSPE. We hereby describe a case of 8 year old boy, who presented with depression and developed symptoms of mania on antidepressant but eventually developed the typical symptoms of SSPE highlighting the importance of keeping in mind the differential diagnosis of organic causes for childhood depression and mania.

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Primary Psychiatric Manifestations of Subacute Sclerosing Panencephalitis: A Case Report and Literature Review

Cited by 9 publications

References 17 publications

Subacute sclerosing panencephalitis

Subacute sclerosing panencephalitis

Case of Subacute Sclerosing Pan-Encephalitis (SSPE) presenting as catatonic schizophrenia

Sub-Acute Sclerosing Panencephalitis Presenting as Anti-Depressant Induced Childhood Mania

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