Clinico-demographic, Investigation and Outcomes Profiles of Subacute Sclerosing Panencephalitis (SSPE) Patients at A Referral Neurology Hospital in Bangladesh

Journal of National Institute of Neurosciences Bangladesh Pub Date : 2019-09-07 DOI:10.3329/jninb.v5i2.43011

M. E. Hussain, Afm Al Masum Khan, Abdulwaheed Adebola Yusuf, Ferdous Mian, N. Islam, B. Debnath, A. Hoque, B. Alam, Q. Mohammad, R. Chowdhury

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Abstract

Background: SSPE is a late complication of measles and is fatal in most cases. Objectives: The purpose of the study was to observe the clinico-demographic, investigation and outcome profiles of SSPE patients. Methodology: This prospective cohort study was conducted in the Department of Neurophysiology at National Institute of Neurosciences and Hospital, Dhaka, Bangladesh from September 2014 to August 2017. Patients of SSPE who were diagnosed by Dyken's Criteria were selected as study population. Details socio-demographic, clinical profiles, investigations and outcome were recorded. The outcome was assessed from the time of first onset of the symptoms till closing of the study. Results: The mean age of the study population was 14.3±4.209 years with the male predominance (73.5%). Majority were from rural area (70.6%) and were of low socio-economic condition (52.9%). The mean age of onset of disease was 13.6±4.30 years. History of previous measles infection was reported in 13(38.2%) cases among which 12(92.3%) cases were vaccinated. The mean age of measles infection was 17.0±15.44 months. The time of first symptom of SSPE from primary measles infection was 11.50±4.80 years. Recurrent fall (47.1%) and myoclonic jerks (17.6%) were the most frequent initial symptoms of the patient. Cognitive decline was observed in 28(82.4%) cases. EEG background was slow in 23(67.6%) patients and periodic burst was observed in all (100.0%) cases. Anti-measles antibody in CSF was positive in all cases. MRI was abnormal in 7(25.9%) cases out of 27 cases. Twelve (35.3%) patients died, 18(52.9%) were alive and 4(11.8%) were lost to follow up when the study was closed. Conclusion: Early aged male from lower socioeconomic condition are found to be suffering from SSPE. Recurrent fall is the commonest initial presentation. Spontaneous recovery can occur in very few patients. Journal of National Institute of Neurosciences Bangladesh, 2019;5(2): 97-100

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孟加拉国一家转诊神经病学医院亚急性硬化性全脑炎(SSPE)患者的临床人口学、调查和结局概况

背景:SSPE是麻疹的晚期并发症，大多数病例是致命的。目的:本研究的目的是观察SSPE患者的临床人口学、调查和结局概况。方法:这项前瞻性队列研究于2014年9月至2017年8月在孟加拉国达卡国家神经科学研究所和医院神经生理学系进行。选择符合Dyken标准的SSPE患者作为研究人群。详细的社会人口统计，临床资料，调查和结果记录。从症状首次出现到研究结束，对结果进行评估。结果:研究人群平均年龄为14.3±4.209岁，男性占73.5%;主要来自农村地区(70.6%)，社会经济条件较低(52.9%)。平均发病年龄为13.6±4.30岁。13例(38.2%)有麻疹感染史，其中12例(92.3%)接种过麻疹疫苗。麻疹感染的平均年龄为17.0±15.44个月。原发性麻疹感染并发SSPE的时间为11.50±4.80年。复发性跌倒(47.1%)和肌阵挛性抽搐(17.6%)是患者最常见的初始症状。认知功能下降28例(82.4%)。23例(67.6%)患者脑电图背景缓慢，所有(100.0%)患者均出现周期性发作。所有病例脑脊液抗麻疹抗体均呈阳性。27例MRI异常7例(25.9%)。研究结束时，死亡12例(35.3%)，存活18例(52.9%)，失访4例(11.8%)。结论:社会经济条件较差的早龄男性易患SSPE。复发性跌倒是最常见的首发症状。很少有病人能自发恢复。孟加拉国国家神经科学研究所学报，2019;5(2):97-100

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Journal of National Institute of Neurosciences Bangladesh

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