Subacute sclerosing panencephalitis in a 24‑month‑old child: a rare rarly onset and alarming presentation

Arshad Mehmood; Javeria Raza Alvi; Sameen Qureshi; Ahmed Bilal; Shaila Ali; Tipu Sultan

doi:10.56310/pjns.v20i02.487

Arshad Mehmood University of Child Health Sciences and Children Hospital Lahore, Pakistan.
Javeria Raza Alvi University of Child Health Sciences and Children Hospital Lahore, Pakistan.
Sameen Qureshi University of Child Health Sciences and Children Hospital Lahore, Pakistan.
Ahmed Bilal University of Child Health Sciences and Children Hospital Lahore, Pakistan.
Shaila Ali University of Child Health Sciences and Children Hospital Lahore, Pakistan.
Tipu Sultan University of Child Health Sciences and Children Hospital Lahore, Pakistan.

DOI: https://doi.org/10.56310/pjns.v20i02.487

Keywords: Subacute sclerosing panencephalitis, Early-onset SSPE, Myoclonic seizures, Measles

Abstract

Subacute sclerosing panencephalitis (SSPE) is a rare, progressive, and fatal neurodegenerative disorder caused by persistent measles virus infection. Early-onset SSPE in children under five years is uncommon but often rapidly progressive. We report a 24‑month-old unvaccinated male who presented with progressive myoclonic seizures, gait difficulty, and rapid neurodevelopmental regression. EEG showed periodic generalized discharges, and CSF measles antibody titers were elevated, fulfilling modified Dyken criteria. The child was classified as stage III SSPE. Symptomatic therapy including anti-seizure medications and supportive care, along with a planned ketogenic diet, was initiated but neurological outcome remained poor. This case emphasizes the aggressive nature of early-onset SSPE and the importance of measles vaccination.