A Rare Case of Subacute Sclerosing Panencephalitis Presenting as Schizophrenia - A Case Report

Subacute sclerosing panencephalitis (SSPE) is a rare, progressive andoften fatal late neurological manifestation of measles infection whichoccurs after a latent period of several years after primary infection inimmunocompetent hosts. It is characterised by mental state changes,myoclonus and often ataxia. In this case, an 18-year-old male presentedwith mood swings, irritability, and cognitive decline, leading to aninitial misdiagnosis of schizophrenia. The misdiagnosis stemmed fromoverlapping psychiatric symptoms, such as behavioural changes,forgetfulness, and decreased attention, as well as the absence ofprominent neurological findings at the onset. The diagnosis is basedon the detection of intrathecal anti-measles antibodies of the IgG classand the presence of the IgM class of antibodies usually confers a badprognosis. Pathological examination reveals inflammatory changesin brain tissue, gliosis, demyelination and typical inclusion bodiescontaining measles viral antigens or RNA.Electroencephalographic findings in SSPE are highly characteristicshowing bilateral generalised high amplitude slow or sharp-slow wavecomplexes. Therapeutic modalities often prove disappointing, theoutcome and prognosis is generally poor and most patients die over aperiod ranging from several months to a few years. The cause of deathis generally respiratory tract infection or involvement of brain stemcentres controlling vital functions. Although the incidence of SSPE hasdramatically declined after successful immunisation programmes, itstill occurs in developing countries where coverage is lower. It is veryimportant to correctly diagnose and manage SSPE and not attributethe symptoms to a mere psychiatric illness. Further research is highlyneeded for early diagnosis and treatment options for these patientsto have a decent quality of life, which at present is difficult. How to cite this article: Gaur I. A Rare Case of Subacute Sclerosing Panencephalitis Presenting as Schizophrenia - A Case Report. J Commun Dis. 2024;56(4):94-96. DOI: https://doi.org/10.24321/0019.5138.202476