Subacute Sclerosing Panencephalitis in a North African Cohort: Findings From the Post-Measles Epidemic Era

Abstract

Subacute sclerosing panencephalitis (SSPE) is a rare, fatal encephalitis caused by chronic measles virus infection. Its recent resurgence, particularly after measles epidemics, underscores the need for vigilance in children. This study describes the clinical, paraclinical, therapeutic features, and prognosis of SSPE in 15 patients. Initial symptoms included gait disturbances, psychomotor regression, and behavioral changes. Neurological examination revealed cognitive decline, visual impairment, hypotonia, pyramidal signs, ataxia, and movement disorders. Electroencephalogram showed periodic delta wave complexes, while brain imaging identified subcortical and periventricular white matter (WM) lesions, brainstem involvement, and progressive cortical-subcortical atrophy on follow-up. All patients tested positive for anti-measles immunoglobulins G in cerebrospinal fluid and blood. Despite treatment, rapid clinical deterioration led to akinetic mutism and neurovegetative symptoms. This study alerts clinicians and radiologists to consider SSPE in children presenting with subacute cognitive decline, myoclonus and epilepsy with periodic complexes, associated with specific WM changes, particularly in the post-epidemic period.