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Subacute Sclerosing Panencephalitis by Krisha McCoy, MS

Definition

Subacute sclerosing panencephalitis (SSPE) is a condition that affects the brain and spine. It is a gradual break down of nerve cells from constant swelling. SSPE is a rare condition that can occur after getting the measles .

When left untreated, SSPE almost always leads to death. Contact your doctor immediately if you think you or your child may have this condition.

Central Nervous System

Causes

SSPE is caused by an altered form of the measles virus. It occurs anywhere from 2-10 years after contracting measles.

Risk Factors

The following factors are thought to increase the risk of SSPE:

Age: 5-15 years old
Gender: male
Measle infection in infancy
Not being vaccinated against measles
Ethnicity:
- Arabs and Sephardic Jews have an incidence that is six times higher than Ashkenazi Jews.
- Caucasians have a four-fold higher incidence than African Americans in the United States.

Symptoms

Symptoms of SSPE may include:

Abnormal behavior
Irritability
Loss of intellectual abilities
Memory loss
Involuntary movements
Seizures
Inability to walk
Speech impairment with poor comprehension
Difficulty swallowing
Blindness
Muteness
Coma

Diagnosis

Your doctor will ask about your child’s symptoms and medical history. A physical exam will be done. Tests that may be done include:

Blood tests—to look for the measles antibody (sign that there was a measle infection)
Electrocardiogram (ECG, EKG)—a test that records the heart’s activity by measuring electrical currents through the heart muscle
CT scan
MRI scan

Treatment

Talk with your doctor about the best treatment plan. Treatment options include:

Supportive Therapy

With advanced disease, tube feedings and nursing care may be necessary.

Medications

Anticonvulsant medications can reduce some symptoms of SSPE. In addition, there is some evidence that certain medications may help stabilize the disease and/or delay its progression. These may include:

Inosine pranobex
Interferon alpha
Interferon beta
Ribavirin

Prevention

The best way to prevent SSPE is to avoid contracting measles. The measles vaccine is generally given at 12-15 months of age and again at 4-6 or 11-12 years. If you have not been vaccinated, avoid contact with people who are infected with measles until all of their symptoms are gone.

RESOURCES:

Centers for Disease Control and Prevention http://www.cdc.gov/
National Institute of Neurological Disorders and Stroke http://www.ninds.nih.gov/

CANADIAN RESOURCES:

Canadian Neurological Sciences Federation http://www.ccns.org/
Public Health Agency of Canada http://www.phac-aspc.gc.ca/

References:

Campbell H, Andrews N, Brown KE, Miller E. Review of the effect of measles vaccination on the epidemiology of SSPE. Int. J. Epidemiol . 2007;36:1134-48.
Complications of measles. Center for Disease Control (CDC) website. Available at: http://www.cdc.gov/measles/about/complications.html . Accessed September 20, 2012.
Measles. EBSCO Health Library website. Available at: http://www.ebscohost.com/thisMarket.php?marketID=14 . Accessed September 20, 2012.
Subacute sclerosing panencephalitis (SSPE). EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . Accessed September 20, 2012.
Subacute sclerosing panencephalitis information page. National Institute of Neurological Disorders and Stroke website. Available at: http://www.ninds.nih.gov/disorders/subacute_panencephalitis/subacute_panencephalitis.htm . Updated February 16, 2011. Accessed September 20, 2012.

Last reviewed September 2012 by Rimas Lukas, MD

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