Objective: To study the frequency of movement Disorders(MD) in patients with Subacute Sclerosing Pan Encephalitis (SSPE). To describe the various type of MD in patients with SSPE To correlate imaging findings with the phenomenology of MD

Background: Subacute sclerosing panencephalitis (SSPE) is a rare, progressive complication of measles characterized by cognitive and motor deterioration, with death typically occurring within 1–3 years of symptom onset. Movement disorders are rarely part of the clinical features of patients with SSPE. We report 13 patients of SSPE who presented with movement disorders along with cognitive dysfunction in our centre. We studied the movement disorder phenomenology, clinical features, radiological features, treatment given in these 13 patients

Method: We prospectively screened consecutive patients with diagnosis of SSPE from our clinic and completed detailed history and examination over a period of six months. Of the 106 patients, 13 patients had movement disorders as a part of their clinical presentation. We recorded video of these patients and staged each patient according to Jabbour staging. We also recorded the various movement disorders encountered in structured proforma. We also evaluated the EEG findings and Neuroimaging findings and tried to correlate it with the type of movement disorder.

Results: The mean age of patients ranged from 7-17 years with mean age of 12.88 ± 0.992 years. There were 8 males and 5 females. Of the 13 patients, 12 had myoclonus, 8 had dystonia, 5 had Parkinsonism, 4 had tremor and 2 had stereotypies. When Jabbour staging was applied 3 were in stage 1, 4 in stage 3 and rest in stage 2.All the patients were given intrathecal α-interferon whereas 5 patients also were on Isosprinosine. Four of the five patients who had Parkinsonism had frontal white matter signal changes on MRI brain. Symptomatic treatment in the form of levodopa, trihexiphenydyl, levetiracetam was also given to patients.

Conclusion: Movement disorders can be an important clinical feature of patients with SSPE. Movement disorder specialists should keep a possibility of this devastating disorder in patients presenting with rapid cognitive decline along with movement disorders.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/movement-disorders-as-a-clinical-feature-of-subacute-sclerosing-pan-encephalitis-expansion-of-phenotypic-spectrum/