Öz
Subacute sclerosing panencephalitis SSPE is a progressive neurodegenerative disease developing after measles infection. It has a bad prognosis. We present here a child with SSPE with unusual brain MRI findings. A 13 yearold girl presented to our child neurology clinic with seizures and worsening neurological symptoms. She only had right basal ganglia putaminal hyperintensity in her brain MRI. A metabolic disorder was more likely with these MRI findings. However her EEG was suggestive of SSPE. A lumbar puncture was performed and it showed high anti-measles antibodies, which provided the definitive diagnosis. In patients with isolated basal ganglia lesions in their MRI, SSPE should be considered in the differential diagnosis
Anahtar Kelimeler
Kaynakça
- Miller C, Farringtom CP, Harbert K. The epidemiology of subacute sclerosing panencephalitis in England and Wales 1970-1989. Int J Epidemiol 1992;21:998-1006.
- Trivedi R, Gupta RK, Agarawal A, Hasan KM, Gupta A, Prasad KN et al. Assesment of white matter damage in subacute sclerosing panencephalitis using quantitative diff usion tensor MR imaging. Am J Neuroradiol 2006;27(8):1712-1716.
- Akdal G, Baklan B, Çakmakçı H, Kovanlıkaya A. MRI follow-up of basal ganglia involvement in subacute sclerosing panencephalitis. Pediatr Neurol 2001;24:393-395.
- Anlar B, Saatçi I, Köse G, Yalaz K. MRI fi ndings in subacute sclerosing panencephalitis. Neurology 1996;47:1278-1283.
- Praveen-kumar S, Sinha S, Taly AB, Jayasree S, Ravi V, Vijayan J, Ravishankar S. Electroencephalographic and imaging profi le in a subacute sclerosing panencehalitis (SSPE) cohort:A correlative study. Clin Neurophysiol 2007;118:1947-1954.
- Woodward KJ, Weinberg PE, Lipton HL. Basal ganglia involvement in subacute sclerosing panencephalitis:CT and MRI demonstration. J Comput Assist Tomogr 1988;12:489-491.
- Sawaishi Y, Yano T, Watanabe Y, Takada G. Migratory basal ganglia lesions in subacute sclerosing panencephalitis (SSPE):Clinical implications of axonal spread. J Neurol Sci 1999;168:137-140.
- Murata R, Matsuoka O, Nakajima S, Kawawaki H, Hattori H, Isshiki G et al. Serial magnetic resonance imaging in subacute sclerosing panencephalitis. Jpn J Psychiatry Neurol 1987;41:277-281.
- Gascon G, Yamani S, Crowell J, Stigsby B, Nester M, Kanaan I et al. Combined oral isoprinosine-intraventricular α interferon therapy for subacute sclerosing panencephalitis. Brain Dev 1993;15:346-355.
Öz
Subakut sklerozan panensefalit SSPE çocukluk çağında görülen, kızamık enfeksiyonuna bağlı gelişen progresif, nörodejeneratif bir hastalıktır. Prognozu oldukça kötüdür. Burada kranial MRG’si sıra dışı olan bir SSPE hastası sunulmaktadır. 13 yaşındaki kız hasta nöbetler ve ilerleyici nörolojik kötüleşme ile başvurmuştur. Kranial MRG’sinde unilateral bazal ganglia putamen tutulumu dışında özellik yoktur. Bu bulgularla MRG’si daha çok metabolik hastalık düşündüren hastanın EEG’si ise SSPE için tipik bulunduğundan BOS’ta kızamık antikoru bakılmış ve pozitif bulunmuştur. Hastaya böylece kesin tanı konarak tedavisine başlanmıştır. MRG’de izole bazal ganglia lezyonu olan hastalarda SSPE, ayırıcı tanıda düşünülmesi gereken bir hastalıktır
Anahtar Kelimeler
Kaynakça
- Miller C, Farringtom CP, Harbert K. The epidemiology of subacute sclerosing panencephalitis in England and Wales 1970-1989. Int J Epidemiol 1992;21:998-1006.
- Trivedi R, Gupta RK, Agarawal A, Hasan KM, Gupta A, Prasad KN et al. Assesment of white matter damage in subacute sclerosing panencephalitis using quantitative diff usion tensor MR imaging. Am J Neuroradiol 2006;27(8):1712-1716.
- Akdal G, Baklan B, Çakmakçı H, Kovanlıkaya A. MRI follow-up of basal ganglia involvement in subacute sclerosing panencephalitis. Pediatr Neurol 2001;24:393-395.
- Anlar B, Saatçi I, Köse G, Yalaz K. MRI fi ndings in subacute sclerosing panencephalitis. Neurology 1996;47:1278-1283.
- Praveen-kumar S, Sinha S, Taly AB, Jayasree S, Ravi V, Vijayan J, Ravishankar S. Electroencephalographic and imaging profi le in a subacute sclerosing panencehalitis (SSPE) cohort:A correlative study. Clin Neurophysiol 2007;118:1947-1954.
- Woodward KJ, Weinberg PE, Lipton HL. Basal ganglia involvement in subacute sclerosing panencephalitis:CT and MRI demonstration. J Comput Assist Tomogr 1988;12:489-491.
- Sawaishi Y, Yano T, Watanabe Y, Takada G. Migratory basal ganglia lesions in subacute sclerosing panencephalitis (SSPE):Clinical implications of axonal spread. J Neurol Sci 1999;168:137-140.
- Murata R, Matsuoka O, Nakajima S, Kawawaki H, Hattori H, Isshiki G et al. Serial magnetic resonance imaging in subacute sclerosing panencephalitis. Jpn J Psychiatry Neurol 1987;41:277-281.
- Gascon G, Yamani S, Crowell J, Stigsby B, Nester M, Kanaan I et al. Combined oral isoprinosine-intraventricular α interferon therapy for subacute sclerosing panencephalitis. Brain Dev 1993;15:346-355.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Bölüm | Case Report |
| Yazarlar | |
| Yayımlanma Tarihi | 1 Haziran 2011 |
| Yayımlandığı Sayı | Yıl 2011Sayı: 2 |