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

Bhat, Bilal Ahmad; Dar, Shabir Ahmad; Hussain, Arshad

doi:10.4172/2378-5756.1000452

Cited by 3 publications

(1 citation statement)

References 8 publications

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“…[7]. However, several atypical presentations are also noted [8][9][10][11]. Post-measles neurological complications include acute encephalitis, measles inclusion body encephalitis, acute disseminated encephalomyelitis (ADEM), and SSPE.…”

Section: Introductionmentioning

confidence: 99%

Electroencephalography Patterns of Subacute Sclerosing Panencephalitis

Ali¹,

Kumar²,

Ullah³

et al. 2021

Cureus

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Introduction and background: This article explores the electroencephalography (EEG) pattern in patients of suspected subacute sclerosing panencephalitis (SSPE) visiting Lady Reading Hospital, Peshawar. Pakistan has a huge deficit of research culture, and limited studies are done on this topic. This study concluded that a typical pattern is the most common EEG pattern, although atypical and normal EEG patterns were also observed. It is worth inclusion into the existing literature and may be used for future literature review of similar studies done elsewhere in Pakistan to give a wider perspective comprised of a larger sample sizeintegrating all studies.Objective: To determine the frequency of different patterns of EEG (typical, atypical, and normal) in SSPE patients.Methodology: Seventy-seven patients of both male and female genders between ages one to 20 years, who were diagnosed with SSPE, were included in the study. Dyken's criteria were used to diagnose the patients. A prior history of previous measles infection with signs and symptoms suggestive of SSPE and positive antimeasles IgG antibodies in the cerebrospinal fluid (CSF) was found in all the patients included in the study. Besides this, typical EEG patterns and raised CSF globulin levels were also used for confirmation of the diagnosis. All the patients fulfilling the above criteria and presenting to the neurology department of Lady Reading Hospital, Peshawar, from February 1, 2019, to November 30, 2019, were included in the study. All the patients underwent the EEG monitoring in the same EEG laboratory and were reported by the same consultant with careful exclusion of any artifacts during the study.Result: There were 59 (76.62%) males and 18 (23.37%) females. The mean age was 15 ± 8.6 years, and the mean duration of symptoms was 4.79 ± 1.68 months. EEG was normal in 14 (18.18%) patients, while 63 (81.81%) patients had an abnormal EEG pattern, with a majority of 53 (84.12%) patients showing periodic delta wave complexes. Only 10 (15.87%) patients showed atypical patterns. Conclusion:Almost all the patients of SSPE showed periodic high-amplitude delta waves complexes, which usually occurs in patients with a disease duration of more than four months. However, further studies with a large sample size are needed for the confirmation of this observation.

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Section: Introductionmentioning

confidence: 99%

Electroencephalography Patterns of Subacute Sclerosing Panencephalitis

Ali¹,

Kumar²,

Ullah³

et al. 2021

Cureus

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The spectrum of psychiatric manifestations in subacute sclerosing panencephalitis: A systematic review of published case reports and case series

Garg,

Kar,

Malhotra

et al. 2024

CNS Spectr.

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Data related to psychiatric manifestations in subacute sclerosing panencephalitis (SSPE) is currently available only in the form of isolated case reports. In this systematic review, we evaluated the spectrum of psychiatric manifestations and their impact on the course and outcome of SSPE. Data were obtained from 4 databases (PubMed, Embase, Scopus, and Google Scholar), with the most recent search conducted on March 27, 2023. The PRISMA guidelines were followed, and the PROSPERO registration number for the protocol is CRD42023408227. SSPE was diagnosed using Dyken’s criteria. Extracted data were recorded in an Excel spreadsheet. To evaluate the quality of the data, the Joanna Briggs Institute Critical Appraisal tool was employed. Our search resulted in 30 published reports of 32 patients. The mean age was 17.9 years. Schizophrenia, catatonia, and poorly characterized psychotic illnesses were the 3 most common psychiatric presentations that were seen in 63% (20/32) of cases. Catatonia was seen in 4 patients. Affective disorders, mania, and depression were reported among 22% (7/32) cases. In approximately 81% (26/32) cases, the course of SSPE was acute fulminant. Treatment with antipsychotic drugs had poor or no response. Out of 17 patients, who received antipsychotic drugs, 6 patients noted severe extrapyramidal adverse effects. SSPE often masquerades as a psychiatric disorder. Unresponsive psychiatric symptoms, early extrapyramidal signs, and progressive encephalopathy indicate SSPE.

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The spectrum of psychiatric manifestations in subacute sclerosing panencephalitis: a systematic review of published case reports and case series

Garg

Kar

Malhotra

et al. 2023

Preprint

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Background Data related to psychiatric manifestations in SSPE is currently available only in form of isolated case reports. In this systematic review, we evaluated the spectrum of psychiatric manifestations and their impact on the course and outcome of SSPE. Methods Data were obtained from four databases (PubMed, Embase, Scopus, and Google Scholar), with the most recent search conducted on 27/03/2023. The PRISMA guidelines were followed, and the PROSPERO registration number for the protocol is CRD42023408227. SSPE was diagnosed using Dyken's criteria. Extracted data were recorded in an Excel spreadsheet. To evaluate the quality of the data, the Joanna Briggs Institute Critical Appraisal tool was employed. Results Our search resulted in 30 published reports of 32 patients. The mean age was 17.9 years. Schizophrenia, catatonia, and poorly characterized psychotic illnesses were the three most common psychiatric presentations (60%) in SSPE cases. Mania or depression was reported among 23% (7/32) cases. In 10% of cases, the initial clinical presentation of SSPE was considered functional/ hysterical. In approximately 81% (26/32) cases, the course of SSPE was rapidly progressive (either acute fulminant or subacute). Treatment with antipsychotic drugs had poor or no response. Out of 17 patients who received antipsychotic drugs 6 patients noted severe extrapyramidal adverse effects, that further deteriorated the clinical condition of the patients. Conclusion Several patients with SSPE inadvertently end up in psychiatric care due to some psychiatric manifestation. Early psychiatric disorders in SSPE are often subtle and diagnosis of SSPE is easily missed.

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

Cited by 3 publications

References 8 publications

Electroencephalography Patterns of Subacute Sclerosing Panencephalitis

Electroencephalography Patterns of Subacute Sclerosing Panencephalitis

The spectrum of psychiatric manifestations in subacute sclerosing panencephalitis: A systematic review of published case reports and case series

The spectrum of psychiatric manifestations in subacute sclerosing panencephalitis: a systematic review of published case reports and case series

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