Introduction:

Subacute sclerosing panencephalitis is a delayed complication of measles in children. It usually follows a stage wise progression spanning over a period of 1to 2 years. I hereby present a case of rapidly progressive sspe over a period of few weeks.

Case vignette:

A 11 year old boy presented with recurrent falls for the past two weeks. He was evaluated outside and his MRI brain and EEG were normal. On examination he was mute, not communicating, recurrent myoclonic jerks, urinary and fecal incontinence, no meninges signs. No history of fever. He had history of measles at 5months of age. Blood metabolic parameters were normal. Thyroid profile and antithyroid peroxidase antibody were negative. CSF analysis showed normal protein and cell count. Microbiological studies including HSV were negative. Serum antibody for autoimmune encephalitis panel was negative. ANA profile was negative. Serum and CSF anti- measles antibody titres were significantly elevated. A repeat EEG showed high voltage poly spike complexes with periodicity for short period. A third EEG done one week later was absolutely normal.

Conclusion:

SSPE should also be considered in rapidly progressive encephalopathies and EEG should be repeated if clinical suspicion is strong as the changes may be transient in the early period.