Subacute sclerosing panencephalitis
Subacute sclerosing panencephalitis (SSPE) is a progressive, disabling, and deadly brain disorder related to measles (rubeola) infection.
The disease develops many years after the measles infection.
SSPE; Subacute sclerosing leukoencephalitis; Dawson encephalitis; Measles - SSPE; Rubeola - SSPE
Normally, the measles virus does not cause brain damage. However, an abnormal immune response to measles or, possibly, certain mutant forms of the virus may cause severe illness and death. This response leads to brain inflammation (swelling and irritation) that may last for years.
SSPE has been reported in all parts of the world, but in western countries it is a rare disease.
Very few cases are seen in the United States since the nationwide measles vaccination program began. SSPE tends to occur several years after a person has measles, even though the person seems to have fully recovered from the illness. Males are more often affected than females. The disease generally occurs in children and adolescents.
Symptoms of SSPE occur in four general stages. With each stage, the symptoms are worse than the stage before:
Exams and Tests
There may be a history of measles in an unvaccinated child. A physical examination may reveal:
The following tests may be performed:
No cure for SSPE exists. Treatment is generally aimed at controlling symptoms. Certain antiviral drugs and drugs that boost the immune system may be tried to slow the progression of the disease.
The following resources can provide more information on SSPE:
SSPE is always fatal. People with this disease die 1 to 3 years after diagnosis. Some people may survive longer.
When to Contact a Medical Professional
Call your health care provider if your child has not completed their scheduled vaccines. The measles vaccine is included in the MMR vaccine.
Immunization against measles is the only known prevention for SSPE. The measles vaccine has been highly effective in reducing the numbers of affected children.
Measles immunization should be done according to the recommended American Academy of Pediatrics and Centers for Disease Control schedule.
Gershon AA. Measles virus (rubeola). In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases, Updated Edition. 8th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 162.
Mason WH. Measles. In: Kliegman RM, Stanton BF, St. Geme JW, Schor NF, eds. Nelson Textbook of Pediatrics. 20th ed. Philadelphia, PA: Elsevier; 2016:chap 246.
Review Date: 7/29/2018
Reviewed By: Amit M. Shelat, DO, FACP, FAAN, Attending Neurologist and Assistant Professor of Clinical Neurology, Stony Brook University School of Medicine, Stony Brook, NY. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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