A 21⁃year⁃old woman with fever, altered mental status, myoclonic jerks and weakness

Abstract

We present the case of a young female student who developed acute encephalopathy and rapid deterioration to vegetative state. She had intermittent fever and experienced behavioral disturbances , walk imbalance and left hemiplegia. The patient’s condition deteriorated dramatically and she was in vegetative state 2 weeks after the initial neurological symptoms .The cerebrospinal fluid (CSF) was clear and acellular, with  normal glucose concentration and protein count . Cerebral MRI showed subcortical, periventricular and corpus callosum lesions  and  cortical dystrophy . EEG showed stereotyped periodic complexes with high-Voltage slow waves occurring synchronously throughout the recording. The presence of high antimeasles antibodies in cerebrospinal fluid and serum confirmed the diagnosis of subacute sclerosing panencephalitis. Oral Ribavirin  was given to the patient. Her condition was follow up to be stable after 2 years. Acute SSPE is an exceptionally rare and little-known form of SSPE with protean symptomatology. Our case reinforces the need to include SSPE as a diagnostic possibility in acute fulminant encephalopathies.

DOI：10.3969/j.issn.1672⁃6731.2012.01.022