Early Bilateral Symmetrical Putaminal Involvement in Subacute Sclerosing Panencephalitis: An Unusual Neuroimaging Pattern

Abstract Subacute sclerosing panencephalitis (SSPE) classically shows parieto-occipital white matter changes on magnetic resonance imaging (MRI). We report an 11-year-old boy with prior measles infection presenting with neuroregression and myoclonus, with electroencephalography (EEG) showing periodic complexes. MRI revealed atypical symmetric putaminal diffusion restriction with frontal white matter changes. Diagnosis was confirmed by elevated cerebrospinal fluid anti-measles IgG. This case highlights an atypical imaging pattern of SSPE, emphasizing the importance of clinical and EEG correlation for early diagnosis.