An initial MRI picture of limbic encephalitis in subacute sclerosing panencephalitis

Abstract

Background: Subacute sclerosing panencephalitis (SSPE) is a rare and severe long-term complication of measles. Hallmarks of this entity include progressive cognitive decline, myoclonia, a generalized periodic pattern on EEG and deep white matter abnormalities on MRI. However, imaging can be normal in early stages.

Aim: We report herein the case of a previously healthy 13-years-old girl with an unusual radiological presentation.

Results: She presented with unilateral myoclonia, cognitive decline with memory impairment and a first brain MRI with swelling of both hippocampi mimicking limbic encephalitis. Measles antibodies were positive in CSF and the EEG showed slow periodic complexes.

Conclusion: This unusual radiological presentation has never been described in SSPE. Relationship between virus and limbic system are discussed.