Mubbashir Zainab, Tharwani Zoaib Habib, Kambar Tilyan, Munawar Sadia, Raphael Ozem, Siddiqui Iman, Nadeem Syeda Ayesha, Amir Ayesha, Ahmed Amina, Bin Zafar Muhammad Daim, Anjum Muhammad Umair, Hasanain Muhammad, Malikzai Abdullah
Department of Pharmacology, Karachi University, Karachi, Pakistan.
Faculty of Medicine, Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan.
Brain Behav. 2025 Feb;15(2):e70292. doi: 10.1002/brb3.70292.
Subacute Sclerosing Panencephalitis (SSPE) is a rare complication of the measles infection. SSPE is a chronic disease of the central nervous system (CNS) that causes encephalitis, leading to the demyelination of neurons in the brain. It affects the brain in 9 months or less and hence subacute, causing encephalitis and lesions in the entire brain, so the term panencephalitis is used.
A comprehensive literature search was conducted using the databases PubMed and Google Scholar starting in April 2024, and all relevant articles were extracted for this review.
A recent surge in SSPE cases in developed countries has been reported. This has been attributed to reduced vaccination, aggravated by misinformation and a decline in immunization after the COVID-19 pandemic. SSPE is a progressive and relatively rare neurological complication of measles, which almost always results in a vegetative state followed by death. It typically presents 10 years following exposure to measles. Manifestations of SSPE are divided into four stages that range from general personality changes to coma. Complications include ocular pathology and eventual blindness, as well as psychiatric illnesses. Treatment options for SSPE include symptomatic control with antiepileptic drugs, interferon combined treatment, vitamin A, ribavirin, and a ketogenic diet for disease modification.
The only prevention for SPPE is through vaccination. Several collaborative efforts have been made with WHO to improve surveillance and increase vaccination, but still many challenges prevail. Better prevention strategies and improved treatment outcomes can only be achieved by enhancing healthcare access, improving public awareness, analyzing community-based data, and studying the genetic and molecular associations of measles and SSPE.
亚急性硬化性全脑炎(SSPE)是麻疹感染的一种罕见并发症。SSPE是一种中枢神经系统(CNS)的慢性疾病,可导致脑炎,进而引起大脑神经元脱髓鞘。它在9个月或更短时间内影响大脑,因此呈亚急性,可导致全脑炎,即在整个大脑中引发脑炎和病变,故而使用“全脑炎”这一术语。
2024年4月起,利用PubMed和谷歌学术数据库进行了全面的文献检索,并提取了所有相关文章用于本综述。
据报道,发达国家近期SSPE病例激增。这归因于疫苗接种率降低,新冠疫情后错误信息以及免疫接种率下降加剧了这一情况。SSPE是麻疹一种渐进性且相对罕见的神经并发症,几乎总会导致植物人状态,随后死亡。它通常在接触麻疹后10年出现。SSPE的表现分为四个阶段,从一般人格改变到昏迷不等。并发症包括眼部病变及最终失明,以及精神疾病。SSPE的治疗选择包括使用抗癫痫药物进行症状控制、干扰素联合治疗、维生素A、利巴韦林以及用于改善病情的生酮饮食。
预防SSPE的唯一方法是通过接种疫苗。已与世卫组织开展了多项合作努力,以加强监测并提高疫苗接种率,但仍存在许多挑战。只有通过增加医疗服务可及性、提高公众意识、分析基于社区的数据以及研究麻疹与SSPE的遗传和分子关联,才能实现更好的预防策略和改善治疗效果。