Atypical magnetic resonance imaging features in subacute sclerosing panencephalitis

Ann Indian Acad Neurol. 2016 Apr-Jun;19(2):275-6. doi: 10.4103/0972-2327.173304.

Abstract

Objectives: Subacute sclerosing panencephalitis (SSPE) is rare chronic, progressive encephalitis that affects primarily children and young adults, caused by a persistent infection with measles virus. No cure for SSPE exists, but the condition can be managed by medication if treatment is started at an early stage.

Methods and results: Heterogeneity of imaging findings in SSPE is not very uncommon. But pial and gyral enhancements are very rarely noticed. Significant asymmetric onset as well as pial-gyral enhancements is not reported. Herein we present a case of 16 years adolescent of SSPE having remarkable asymmetric pial-gyral enhancements, which were misinterpreted as tubercular infection.

Conclusion: Early diagnosis and treatment is encouraging in SSPE, although it is not curable with current therapy. Clinico-radiological and electrophysiological correlation is very important in diagnosis of SSPE, more gravely in patients having atypical image findings as in our index case.

Keywords: Encephalitis; measles; myoclonic jerks; pial and gyral enhancement; subacute sclerosing panencephalitis (SSPE).