Subacute Sclerosing Panencephalitis Presenting as Schizophrenia With an Alpha Coma Pattern in a Child

Subacute sclerosing panencephalitis, a progressive neurodegenerative disorder of the central nervous system, can present atypically with uncharacteristic electroencephalographic (EEG) features at its onset albeit typically with progressive mental deterioration, behavioral changes, and myoclonic jerk...

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Bibliographic Details
Published in:Journal of child neurology 2014-10, Vol.29 (10), p.NP111-NP113
Main Authors: Kartal, Ayşe, Kurt, Ayşegül Neşe Çitak, Gürkaş, Esra, Aydin, Kurşad, Serdaroğlu, Ayşe
Format: Article
Language:English
Subjects:
Adolescent
Brain - physiopathology
Coma - diagnosis
Coma - physiopathology
Diagnosis, Differential
Electroencephalography
Female
Humans
Schizophrenia - diagnosis
Subacute Sclerosing Panencephalitis - diagnosis
Subacute Sclerosing Panencephalitis - drug therapy
Subacute Sclerosing Panencephalitis - physiopathology
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Summary:Subacute sclerosing panencephalitis, a progressive neurodegenerative disorder of the central nervous system, can present atypically with uncharacteristic electroencephalographic (EEG) features at its onset albeit typically with progressive mental deterioration, behavioral changes, and myoclonic jerks. An atypical presentation of subacute sclerosing panencephalitis can lead to a delay in diagnosis, thus hindering early treatment. Herein, we describe a 14-year-old girl who presented with insomnia, amnesia, auditory and visual hallucinations. The patient’s electroencephalography on admission showed an alpha coma pattern. In spite of antipsychiatric treatment (olanzapine 20 mg/d) for 3 months, a progressive deterioration in neurologic function was observed. Subacute sclerosing panencephalitis was suspected and diagnosis was confirmed by increased titers of measles antibodies in the cerebrospinal fluid. The attention of pediatricians should be drawn to psychiatric symptoms as possible initial presentations of subacute sclerosing panencephalitis in order to avoid needless diagnostic and treatment procedures.
ISSN:0883-0738
1708-8283
DOI:10.1177/0883073813507484