Status Dystonicus: An Atypical Presentation of Subacute Sclerosing Panencephalitis

Excerpt

To the Editor: A 14-y-old boy, previously healthy but unimmunized, presented with an acute onset of generalized dystonic movements that rapidly progressed in severity over two days, leading to status dystonicus. There was no history of prodromal febrile illness, drug intake, family history of similar illnesses, cognitive decline, other movement disorders, seizures, or vision or hearing impairments. He had a viral exanthematous illness at three years of age. The examination revealed normal sensorium, bipyramidal signs, and status dystonicus. Magnetic resonance imaging of the brain (Fig. 1), cerebrospinal fluid (CSF) examination, including cytology, sugar, protein, and neuronal surface autoantibodies were unremarkable. Electroencephalogram showed generalized periodic discharges with type 2 Radermecker complexes without time-locked myoclonus. CSF anti-measles antibodies were strongly positive, suggesting a diagnosis of subacute sclerosing panencephalitis (SSPE). …