ICNC Abstracts, ICNC 2018

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FATAL DIAGNOSIS OF SSPE TO TREATABLE CAUSE OF AUTOIMMUNE ENCEPHALITIS
chandra sadanandavalli retnaswami

Last modified: 2018-09-09

Abstract


Introduction:

SSPE is a  fatal slow virus disease which has clinical ,radiological, electrophysiological and biochemical equivalents. In this paper we present details of a case series where significant elevation of measles antibody titres were found in patients who did not have other evidence of SSPE.

Methods :

Patients seen by our team  with elevated  with anti measles antibody in CSF during 5 yr period (2012-2016)  IgG > 1:25 considered  significant as per out institute normative data.  Clinical details, EEG.MRI ,autoimmune antibody profile ,USS, complete haematological  work up  done. During fallow up clinical features reassesd.

Results :

Out of 40 patients who had CSF antimeasles antibody positivity, 8 patients didn't have full spectrum of SSPE and had other antibodies positive(diagnosed as autoimmune encephalitis).  They responded very well to immunomodulation. Compared to 32 patients with SSPE and antimeasles antibody  positive , these 8 patients belonged to the higher age, had significant psychosis (P = 0.02), incontinence of bowel and bladder (P = 0.0001), significant limb weakness (P = 0.028) and involuntary movements like chorea,fasciobrachial dystonic seizures which had been misinterpreted as slow myoclonus elsewhere . Immunofixation done confirmed these cases as not SSPE. EEG  is a simple sensitive differentiating tool.

Conclusion:

Elevated  Measles antibody in CSF in can occur in non   SSPE conditions. As this is a antibody based test and clinical and  electrophysiogical correlation is mandatory before the fatal diagnosis is given to patient .


Keywords


neuroimmunology

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