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Fulminant Subacute Sclerosing Panencephalitis in an Individual With a Perinatally Acquired Human Immunodeficiency Virus Infection

Ajith Sivadasan, DM; Mathew Alexander, DM; Anil Kumar Patil, DM; Krishnan Balagopal, DM; Zeyaur Rahman Azad, DM
Arch Neurol. 2012;69(12):1644-1647. doi:10.1001/archneurol.2012.486.
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Background  Case reports of subacute sclerosing panencephalitis (SSPE) in individuals with human immunodeficiency virus (HIV) infection are scarce, and the natural history is unclear. To our knowledge, a fulminant presentation has not yet been described.

Objective  To describe a case of fulminant SSPE in an individual with a perinatally acquired HIV infection.

Design  Case report and literature review.

Setting  Christian Medical College Hospital, Vellore, India.

Patient  A 17-year-old boy with a perinatally acquired HIV infection.

Results  The patient presented with subacute-onset cognitive decline and myoclonic jerks with rapid deterioration of health (the patient died within 12 weeks of onset). The findings from magnetic resonance imaging and electroencephalography and the cerebrospinal fluid and serum measles antibody titers were suggestive of SSPE. The fulminant presentation in this case needs to be noted.

Conclusions  Along with the better life expectancy of HIV-infected individuals, there may be an increase in the incidence of SSPE in this population. Fulminant SSPE may be added to the spectrum of measles-associated neurological disorders in HIV.

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Grahic Jump Location

Figure 1. T2-weighted axial fluid-attenuated inversion recovery sequence showing focal asymmetric nonenhancing subcortical white matter hyperintensities in both frontoparietal regions (right more than left).

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Grahic Jump Location

Figure 2. Electroencephalogram showing paroxysmal periodic bursts of high-amplitude sharp- and slow-wave complexes seen bilaterally and synchronously at intervals of 3 to 4 seconds.

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Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

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