Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
Neurological Sciences

21-03-2024 | Encephalitis | Review Article

Clinical features, pathogenesis, pathology, neuroimaging, clinical course and outcome of measles inclusion-body encephalitis: a systematic review of published case reports and case series

Authors: Ravindra Kumar Garg, Vinay Suresh, Swastika Suvirya, Imran Rizvi, Neeraj Kumar, Shweta Pandey

Published in: Neurological Sciences

Login to get access

Abstract

Measles inclusion-body encephalitis (MIBE) is rare, with insights largely from case studies. We systematically analyzed subacute Sclerosing Panencephalitis (SSPE) cases in immunocompromised patients, identifying distinctive clinical and neuroimaging features. These findings could facilitate MIBE diagnosis without the need for brain biopsies. Our systematic review on MIBE and HIV-related SSPE adhered to PRISMA guidelines and was registered with PROSPERO. We searched multiple databases and followed a detailed inclusion process with independent reviews and quality assessment. Data on patient demographics, clinical features, and outcomes were compiled. A review of 39 studies on 49 MIBE patients and 8 reports on HIV-positive SSPE patients was conducted. Acute lymphoblastic leukemia, HIV, organ transplants, and malignancies were common precursors to MIBE. Perinatal HIV was prevalent among SSPE cases. Seizures were the primary symptom in MIBE, often drug-resistant and progressing to status epilepticus or epilepsia partialis continua, whereas periodic myoclonus was universal in SSPE. Neuroimaging showed distinct patterns for each group, and histopathology confirmed measles virus presence in 39% of MIBE cases. MIBE patients typically progressed to coma and death. In conclusion, MIBE and SSPE in HIV-infected patients present with distinct clinical pictures but identical brain pathological abnormalities.
Appendix
Available only for authorised users
Literature
1.
2.
Bonthius DJ (2023) Measles Virus and the Central Nervous System: An Update. Semin Pediatr Neurol 47:101078PubMedCrossRef
3.
Patterson MC (2020) Neurological Complications of Measles (Rubeola). Curr Neurol Neurosci Rep 20(2):2PubMedCrossRef
4.
5.
6.
7.
8.
Della Gatta AN, Rizzo R, Pilu G, Simonazzi G (2020) Coronavirus disease 2019 during pregnancy: a systematic review of reported cases. Am J Obstet Gynecol 223:36–41PubMedPubMedCentralCrossRef
9.
Jindal A, Suri D, Gupta K, Kumar A, Pandiarajan V, Pilania RK, Guleria S, Rawat A, Vyas S, Bhatia A, Singh S, Radotra BD (2023) Uncommon histopathological features of cytomegalovirus encephalitis and measles inclusion body encephalitis on autopsy in two patients with primary immunodeficiency. Clin Neuropathol 42(1):15–25PubMedCrossRef
10.
Turrini I, Contaldo I, Quintiliani M, Genovese O, Gessi M, Onesimo R (2022) Post Infectious Measles Encephalitis: Challenges and Pitfalls. Ann Clin Case Rep 7:2092
11.
Chakraborty AP, Ray A, Mukherjee D, Gupta S, Pandit A, Dubey S (2021) Subacute measles encephalitis in a case of late presenting congenital HIV with epilepsia partialis continua as the first manifestation: A case report. J Family Med Prim Care 10(9):3502–3504PubMedPubMedCentralCrossRef
12.
Costales C, Sahoo MK, Huang C, Guimaraes CV, Born D, Kushner L, Gans HA, Doan TA, Pinsky BA (2022) Vaccine-Associated Measles Encephalitis in Immunocompromised Child, California, USA. Emerg Infect Dis 28(4):906–908PubMedPubMedCentralCrossRef
13.
Rodriguez C, Gouilh MA, Weiss N, Stroer S, Mokhtari K, Seilhean D, Mathon B, Demontant V, N’Debi M, Gricourt G, Woerther PL, Pawlotsky JM, Stefic K, Marlet J, Dequin PF, Guillon A, Pourcher V, Boutolleau D, Vabret A, Burrel S (2020) Fatal Measles Inclusion-Body Encephalitis in Adult with Untreated AIDS, France. Emerg Infect Dis 26(9):2231–2234PubMedPubMedCentralCrossRef
14.
Lytvyn H, Basa N, Stasiv M, Troyanovska O, Dorosh O (2020) Difficulties in diagnosing of measles inclusion body encephalitis in a child with acute lymphoblastic leukemia. IDCases 21:e00877PubMedPubMedCentralCrossRef
15.
Aldecoa I, Archilla I, Herrero L, Garcia F, Torres B, Gaig C, Fernández S, Marcos MÁ, Gelpi E (2020) Measles inclusion body encephalitis. Clin Neuropathol 39(4):148–151PubMedPubMedCentralCrossRef
16.
Maderna E, Tagliavini F, Giaccone G (2016) Measles Inclusion-Body Encephalitis: Neuronal Phosphorylated Tau Protein is Present in the Biopsy but not in the Autoptic Specimens of the Same Patient. Brain Pathol 26(5):673PubMedPubMedCentralCrossRef
17.
Baldolli A, Dargère S, Cardineau E, Vabret A, Dina J, de La Blanchardière A, Verdon R (2016) Measles inclusion-body encephalitis (MIBE) in a immunocompromised patient. J Clin Virol 81:43–46PubMedCrossRef
18.
Katrak SM, Mahadevan A, Taly AB, Sinha S, Shankar SK (2010) A 16-year old male with cortical blindness and focal motor seizures. Ann Indian Acad Neurol 13(3):225–232PubMedPubMedCentralCrossRef
19.
Turner A, Jeyaratnam D, Haworth F, Sinha MD, Hughes E, Cohen B, Jin L, Kidd IM, Rigden SP, MacMahon E (2006) Measles-associated encephalopathy in children with renal transplants. Am J Transplant 6(6):1459–1465PubMedCrossRef
20.
Freeman AF, Jacobsohn DA, Shulman ST, Bellini WJ, Jaggi P, de Leon G, Keating GF, Kim F, Pachman LM, Kletzel M, Duerst RE (2004) A new complication of stem cell transplantation: measles inclusion body encephalitis. Pediatrics 114(5):e657–e660PubMedCrossRef
21.
Croxson MC, Anderson NE, Vaughan AA, Hutchinson DO, Schroeder BA, Cluroe AD, Hyatt AD (2002) Subacute measles encephalitis in an immunocompetent adult. J Clin Neurosci 9(5):600–604PubMedCrossRef
22.
Gazzola P, Cocito L, Capello E, Roccatagliata L, Canepa M, Mancardi GL (1999) Subacute measles encephalitis in a young man immunosuppressed for ankylosing spondylitis. Neurology 52(5):1074–1077PubMedCrossRef
23.
Bitnun A, Shannon P, Durward A, Rota PA, Bellini WJ, Graham C, Wang E, Ford-Jones EL, Cox P, Becker L, Fearon M, Petric M, Tellier R (1999) Measles inclusion-body encephalitis caused by the vaccine strain of measles virus. Clin Infect Dis 29(4):855–861PubMedCrossRef
24.
Poon TP, Tchertkoff V, Win H (1998) Subacute measles encephalitis with AIDS diagnosed by fine needle aspiration biopsy. A case report. Acta Cytol 42(3):729–733PubMedCrossRef
25.
Budka H, Urbanits S, Liberski PP, Eichinger S, Popow-Kraupp T (1996) Subacute measles virus encephalitis: a new and fatal opportunistic infection in a patient with AIDS. Neurology 46(2):586–587PubMedCrossRef
26.
Chen RE, Ramsay DA, deVeber LL, Assis LJ, Levin SD (1994) Immunosuppressive measles encephalitis. Pediatr Neurol 10(4):325–327PubMedCrossRef
27.
Hughes I, Jenney ME, Newton RW, Morris DJ, Klapper PE (1993) Measles encephalitis during immunosuppressive treatment for acute lymphoblastic leukaemia. Arch Dis Child 68(6):775–778PubMedPubMedCentralCrossRef
28.
Mustafa MM, Weitman SD, Winick NJ, Bellini WJ, Timmons CF, Siegel JD (1993) Subacute measles encephalitis in the young immunocompromised host: report of two cases diagnosed by polymerase chain reaction and treated with ribavirin and review of the literature. Clin Infect Dis 16(5):654–660PubMedCrossRef
29.
Colamaria V, Marradi P, Merlin D, Moser C, Dulac O, Dompieri P, Dalla BB (1989) Acute measles encephalitis of the delayed type in an immunosuppressed child. Brain Dev 11(5):322–326PubMedCrossRef
30.
Baczko K, Liebert UG, Cattaneo R, Billeter MA, Roos RP, ter Meulen V (1988) Restriction of measles virus gene expression in measles inclusion body encephalitis. J Infect Dis 158(1):144–150PubMedCrossRef
31.
Ohuchi M, Ohuchi R, Mifune K, Ishihara T, Ogawa T (1987) Characterization of the measles virus isolated from the brain of a patient with immunosuppressive measles encephalitis. J Infect Dis 156(3):436–441PubMedCrossRef
32.
Baram TZ, Norman MG (1987) Encephalopathy in a 14-year-old boy with leukemia in remission. Pediatr Neurosci 13(1):52–60PubMedCrossRef
33.
Ch’ien LT, Price RA, Murti KG, Ochs J (1983) Fatal subacute immunosuppressive measles encephalitis (SIME) in children with acute lymphocytic leukemia–clinical, electroencephalographic, and computerized tomographic scan features. Clin Electroencephalogr 14(4):214–220PubMedCrossRef
34.
Chadwick DW, Martin S, Buxton PH, Tomlinson AH (1982) Measles virus and subacute neurological disease: an unusual presentation of measles inclusion body encephalitis. J Neurol Neurosurg Psychiatry 45(8):680–684PubMedPubMedCentralCrossRef
35.
Olding-Stenkvist E, Forsgren M, Henley D, Kreuger A, Lundmark KM, Nilsson A, Wadell G (1982) Measles encephalopathy during immunosuppression: failure of interferon treatment. Scand J Infect Dis 14(1):1–4PubMedCrossRef
36.
Roos RP, Graves MC, Wollmann RL, Chilcote RR, Nixon J (1981) Immunologic and virologic studies of measles inclusion body encephalitis in an immunosuppressed host: the relationship to subacute sclerosing panencephalitis. Neurology 31(10):1263–1270PubMedCrossRef
37.
Spalke G, Eschenbach C (1979) Infantile cortical measles inclusion body encephalitis during combined treatment of acute lymphoblastic leukemia. J Neurol 220(4):269–277PubMedCrossRef
38.
Agamanolis DP, Tan JS, Parker DL (1979) Immunosuppressive measles encephalitis in a patient with a renal transplant. Arch Neurol 36(11):686–690PubMedCrossRef
39.
Wolinsky JS, Swoveland P, Johnson KP, Baringer JR (1977) Subacute measles encephalitis complicating Hodgkin’s disease in an adult. Ann Neurol 1(5):452–457PubMedCrossRef
40.
Nihei K, Kamoshita S, Mizutani H, Kitayama T, Nishimura H (1977) Atypical subacute sclerosing panencephalitis. Acta Neuropathol 38(2):163–166PubMedCrossRef
41.
Lyon G, Ponsot G, Lebon P (1977) Acute measles encephalitis of the delayed type. Ann Neurol 2(4):322–327PubMedCrossRef
42.
Drysdale HC, Jones LF, Oppenheimer DR, Tomlinson AH (1976) Measles inclusion-body encephalitis in a child with treated acute lymphoblastic leukaemia. J Clin Pathol 29(10):865–872PubMedPubMedCentralCrossRef
43.
Sluga E, Budka H, Jellinger K, Pichler E. SSPE-like inclusion body disorder in treated childhood leukemia. Malignant Lymphomas of the Nervous System: International Symposium; 1975: Springer; 1975. p. 267–72
44.
45.
ter Meulen V, Müller D, Käckell Y, Katz M, Meyermann R (1972) Isolation of infectious measles virus in measles encephalitis. Lancet 2(7788):1172–1175PubMedCrossRef
46.
Shaw CM, Buchan GC, Carlson CB (1967) Myxovirus as a possible etiologic agent in subacute inclusion-body encephalitis. N Engl J Med 277(10):511–515PubMedCrossRef
47.
48.
Vidhale TA, Gupta HR, Prafulla Jaya R, Pustake M (2021) Fulminant subacute sclerosing panencephalitis (SSPE) presented with acute hemiparesis in a 13-year-old girl with perinatally acquired HIV infection. BMJ Case Rep 14(9):e241205PubMedPubMedCentralCrossRef
49.
Kumari M, Shah I, Shetty NS, Kulkarni S (2020) Subacute Sclerosing Panencephalitis (SSPE) in HIV Infected Child. Indian J Pediatr 87(3):241PubMedCrossRef
50.
Gupta A, Kushwaha S, Manzoor M, Tarfarosh SFA (2017) Subacute Sclerosing Panencephalitis in a Child Suffering from Human Immunodeficiency Virus on “Highly Active Antiretroviral Therapy” - Can This be Another Instance of Immune Reconstitution Inflammatory Syndrome? Cureus 9(6):e1346PubMedPubMedCentral
51.
Manesh A, Moorthy M, Bandopadhyay R, Rupali P (2017) HIV-associated sub-acute sclerosing panencephalitis - an emerging threat? Int J STD AIDS 28(9):937–939PubMedCrossRef
52.
Maurya PK, Thakkar MD, Kulshreshtha D, Singh AK, Thacker AK (2016) Subacute Sclerosing Panencephalitis in a Child with Human Immunodeficiency Virus Co-Infection. Clin Med Res 14(3–4):156–158PubMedPubMedCentralCrossRef
53.
Muthusamy K, Yoganathan S, Thomas MM, Alexander M, Verghese VP (2015) Subacute sclerosing panencephalitis in a child with human immunodeficiency virus (HIV) infection on antiretroviral therapy. Ann Indian Acad Neurol 18(1):96–98PubMedPubMedCentral
54.
Sivadasan A, Alexander M, Patil AK, Balagopal K, Azad ZR (2012) Fulminant subacute sclerosing panencephalitis in an individual with a perinatally acquired human immunodeficiency virus infection. Arch Neurol 69(12):1644–1647PubMedCrossRef
55.
Koppel BS, Poon TP, Khandji A, Pavlakis SG, Pedley TA (1996) Subacute sclerosing panencephalitis and acquired immunodeficiency syndrome: role of electroencephalography and magnetic resonance imaging. J Neuroimaging 6(2):122–125PubMedCrossRef
56.
Nath A, Johnson TP (2022) Mechanisms of viral persistence in the brain and therapeutic approaches. FEBS J 289(8):2145–2161PubMedCrossRef
57.
Watanabe S, Shirogane Y, Sato Y, Hashiguchi T, Yanagi Y (2019) New Insights into Measles Virus Brain Infections. Trends Microbiol 27(2):164–175PubMedCrossRef
58.
Mathieu C, Bovier FT, Ferren M, Lieberman NAP, Predella C, Lalande A, Peddu V, Lin MJ, Addetia A, Patel A, Outlaw V, Corneo B, Dorrello NV, Briese T, Hardie D, Horvat B, Moscona A, Greninger AL, Porotto M (2021) Molecular Features of the Measles Virus Viral Fusion Complex That Favor Infection and Spread in the Brain. mBio. 12(3):e0079921PubMedCrossRef
59.
McQuaid S, Cosby SL, Koffi K, Honde M, Kirk J, Lucas SB (1998) Distribution of measles virus in the central nervous system of HIV-seropositive children. Acta Neuropathol 96(6):637–642PubMedCrossRef
60.
61.
Mathieu C, Ferren M, Jurgens E, Dumont C, Rybkina K, Harder O, Stelitano D, Madeddu S, Sanna G, Schwartz D, Biswas S, Hardie D, Hashiguchi T, Moscona A, Horvat B, Niewiesk S, Porotto M (2019) Measles Virus Bearing Measles Inclusion Body Encephalitis-Derived Fusion Protein Is Pathogenic after Infection via the Respiratory Route. J Virol 93(8):e01862-e1918PubMedPubMedCentralCrossRef
62.
Bovier FT, Rybkina K, Biswas S, Harder O, Marcink TC, Niewiesk S, Moscona A, Alabi CA, Porotto M (2021) Inhibition of Measles Viral Fusion Is Enhanced by Targeting Multiple Domains of the Fusion Protein. ACS Nano 15(8):12794–12803PubMedPubMedCentralCrossRef
Metadata
Title
Clinical features, pathogenesis, pathology, neuroimaging, clinical course and outcome of measles inclusion-body encephalitis: a systematic review of published case reports and case series
Authors
Ravindra Kumar Garg
Vinay Suresh
Swastika Suvirya
Imran Rizvi
Neeraj Kumar
Shweta Pandey
Publication date
21-03-2024
Publisher
Springer International Publishing
Published in
Neurological Sciences
Print ISSN: 1590-1874
Electronic ISSN: 1590-3478
DOI
https://doi.org/10.1007/s10072-024-07480-1