Subacute sclerosing panencephalitis presenting as severe depression in an adult

BMJ Case Rep. 2024 May 2;17(5):e259111. doi: 10.1136/bcr-2023-259111.

Abstract

Subacute sclerosing panencephalitis (SSPE) is a fatal disorder that occurs as a rare complication of childhood measles. Symptoms typically manifest between the ages of 5 and 15. While the incidence of SSPE is declining globally, it is still prevalent in regions where measles remains common and vaccination rates are low due to poverty and lack of health education. Diagnosing SSPE can be challenging, particularly when patients exhibit unusual symptoms. A thorough clinical evaluation, including vaccination history, physical examination, electroencephalogram (EEG) and Cerebrospinal fluid (CSF) analysis, can help in making a diagnosis. We present the case of a young woman in her early 20s who initially experienced depressive symptoms, followed by myoclonus, dementia and visual impairment. The patient was ultimately diagnosed with SSPE based on characteristic EEG findings, neuroimaging results, CSF analysis and elevated serum measles antibody levels.

Keywords: Neurology; Psychiatry.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Depression / diagnosis
  • Depression / etiology
  • Diagnosis, Differential
  • Electroencephalography*
  • Female
  • Humans
  • Measles / complications
  • Measles / diagnosis
  • Myoclonus / diagnosis
  • Myoclonus / etiology
  • Subacute Sclerosing Panencephalitis* / complications
  • Subacute Sclerosing Panencephalitis* / diagnosis
  • Young Adult