Disease-Modifying Therapy in Subacute Sclerosing Panencephalitis: An Area of Darkness

• Published in: Annals of the Indian Academy of Neurology 2023-01, Vol.26 (1), p.3-9
• Main Authors: Garg, Divyani, Sharma, Suvasini
• Format: Article
• Language: English
• Subjects: Antiviral drugs; Biological response modifiers; Case reports; Central nervous system; Development and progression; Diet therapy; Drug therapy; Drug therapy, Combination; Immunotherapy; Interferon; isoprinosine; ketogenic diet; Methods; Neurodegenerative diseases; Panencephalitis; Ribavirin; sspe; Subacute sclerosing panencephalitis; View Point; α-Interferon
• ISSN: 0972-2327; 1998-3549
• DOI: 10.4103/aian.aian_655_22

Subacute sclerosing panencephalitis (SSPE) is a neurodegenerative disorder because of the persistence of mutated measles virus in the central nervous system. Till date, no curative therapy has been established for SSPE. Multiple drugs have been tried to modify the disease process but have shown mild to moderate benefit at best. It is also challenging to attribute the relative success of some strategies described in single case reports because of the known phenomenon of spontaneous improvement in 5% of patients with SSPE. Critical gaps in understanding the pathophysiological processes involved exist. Current therapies such as interferon alfa require invasive strategies for administration by the intraventricular or intrathecal route, with varying dosage regimens. Oral therapies such as isoprinosine and ribavirin are expensive and not readily available in resource-constrained settings. Most of the evidence so far favors the use of combinational regimens. In this viewpoint, we critically summarize the current evidence on disease-modifying strategies in the context of our region.