Affiliations: Department of Pediatrics, 75th Year Hospital,
Gaziantep, Turkey | Department of Nuclear Medicine, Gaziantep University
Faculty of Medicine, Gaziantep, Turkey | Department of Pediatrics, Gaziantep Children's
Hospital, Gaziantep, Turkey | Department of Nuclear Medicine, Gaziantep University
Faculty of Medicine, Gaziantep, Turkey | Department of Pediatrics, Gaziantep University Faculty
of Medicine, Gaziantep, Turkey
Note: [] Correspondence: Dr. Kutluhan Yılmaz, M.D., Department
of Pediatrics, Gaziantep University, Faculty of Medicine, Gaziantep, Turkey.
Tel.: +90 342 360 6060; Fax: +90 342 360 3928; E-mail: drkutluhan@yahoo.com
Abstract: We report a 9-year-old boy with atypical presentation of subacute
sclerosing panencephalitis (SSPE). He was admitted due to staring spells and
cognitive deterioration. Electroencephalography (EEG) demonstrated bilaterally
symmetrical, synchronous, frontal sharp-and-slow wave discharges in 80% of
the record. Diazepam or midazolam administration during EEG recording
attenuated the sharp-and-wave discharges, but revealed no periodic complexes.
Magnetic resonance imaging delineated bilateral frontal T2-weighted
hyperintense foci. Fluorodeoxyglucose-positron emission tomography imaging
indicated bilaterally decreased glucose metabolism in frontal cortex. The other
laboratory tests including measles antibody in cerebrospinal fluid and serum
suggested no specific etiology. Interestingly, a month later, the previously
detected sharp-and-slow wave discharges disappeared, and periodic slow-wave
paroxysms appeared on EEG recording. Measles antibody titers showed
seroconversion and confirmed the diagnosis of SSPE. The present case suggests
that clinicians be cautious while excluding SSPE.
Keywords: SSPE, nonconvulsive status epilepticus, PET
