pediatrics
Subacute Sclerosing Panencephalitis (SSPE)
Introduction
Subacute sclerosing panencephalitis is a progressive, usually fatal brain disorder occurring months to usually years after an attack of measles. It causes mental deterioration, myoclonic jerks, and seizures. Diagnosis involves electroencephalography, CT or MRI, cerebrospinal fluid examination, and measles serologic testing. Treatment is supportive. Subacute sclerosing panencephalitis (SSPE) is thought to be a persistent Measles . The measles virus is present in brain tissue in patients with this disease. Historically, SSPE occurred in approximately 7 to 300 cases per million people who had wild measles and in approximately 1 case per million people who received measles vaccine; post-vaccination cases are thought to be due to unrecognized measles before vaccination. Males are more often affected. The risk of developing SSPE is highest in people who contract measles at < 2 years of age. Onset is usually before age 20. SSPE is exceedingly rare in the United States and Western Europe because of widespread Measles, Mumps, and Rubella (MMR) Vaccine . However, analyses of more recent measles outbreaks suggest that the incidence of SSPE may be higher than previously thought, perhaps as high as 40 to 1700 cases per million measles cases ( 