PDF(Pubmed)
Abstract：
This study presents a case of subacute sclerosing panencephalitis (SSPE), a rare neurologic disorder characterized by brain inflammation, typically triggered by measles virus reactivation or an abnormal immune response to it. This case involves a five-year-old male child with persistent fever, declining motor function, excessive sleepiness, and myoclonic jerks. MRI indicated potential ischemic changes or encephalitis, while electroencephalography showed SSPE-consistent patterns. Further investigations confirmed SSPE, with elevated IgG levels in serum and cerebrospinal fluid (CSF) and positive measles IgG antibodies in CSF. Treatment included isoprinosine, lamivudine, and intrathecal interferon-alpha for symptom management and disease progression. Despite atypical SSPE features, subclinical measles infection was considered a probable cause. The patient showed partial improvement post-treatment and was discharged for follow-up. By reporting this case, we would like to emphasize clinical judgment, early detection of the symptoms, and lateral thinking to diagnose fatal conditions such as post-measles SSPE, even in fully immunized patients.
摘要：
本研究介绍了一例亚急性硬化性全脑炎（SSPE），一种以脑部炎症为特征的罕见神经系统疾病，通常由麻疹病毒重新激活或对其异常免疫反应触发。这宗个案涉及一名五岁男童持续发烧,下降的运动功能，过度困倦,和肌阵挛性抽搐。MRI提示潜在的缺血性改变或脑炎，而脑电图显示SSPE一致的模式。进一步的调查证实了SSPE，血清和脑脊液（CSF）中IgG水平升高，CSF中麻疹IgG抗体阳性。治疗包括异丙霉素，拉米夫定,和鞘内干扰素-α用于症状管理和疾病进展。尽管SSPE功能不典型，亚临床麻疹感染被认为是可能的原因.患者在治疗后表现出部分改善，并出院接受随访。通过报告这个案子,我们想强调临床判断，早期发现症状，和横向思维来诊断致命疾病，如麻疹后SSPE，即使是完全免疫的患者。
