Chettouh Hanane, Haddad Karima, Mahieddine Nafissa, Mekki Azzedine, Zeroual Zoulikha, Berrou Zouhir, Rezzoug Souhaila
Nafissa Hamoud University Hospital Center, Algiers, Algeria.
Nafissa Hamoud University Hospital Center, Algiers, Algeria.
Arch Pediatr. 2025 Apr;32(3):175-183. doi: 10.1016/j.arcped.2024.11.010. Epub 2025 Mar 19.
Subacute sclerosing panencephalitis (SSPE), a progressive inflammatory neurodegenerative disease of the central nervous system caused by the measles virus, is experiencing a significant resurgence following recent measles epidemics. This study aimed to investigate the pathology of SSPE in early childhood and determine its clinical, electrophysiological, and radiological characteristics.
This retrospective, descriptive study was conducted at the Pediatric Department of Nafissa Hamoud University Hospital in Algiers. The study included children aged 2-6 years who were hospitalized for subacute neurological disorders. Data collection spanned a 3-year period from January 1, 2020, to December 31, 2022.
A total of 47 patients were examined, comprising 37 boys and 10 girls. The average age was 45.9 months (range: 24-72 months). Notably, 41 (87 %) of the patients had not received measles vaccination, and 37 (80 %) had contracted the measles virus, with 31 cases (83.8 %) occurring in children under 1 year of age. SSPE manifested approximately 3 years after infection (range: 1-5 years). Clinical events primarily included myoclonic seizures (26 cases), tonic-clonic seizures (6 cases), atonic seizures (6 cases), and focal seizures (3 cases); movement disorders were observed in 25 patients, and cognitive decline in 28 patients. Encephalitis manifestations, such as alterations in consciousness or behavior and psychiatric symptoms, were frequently observed. Electroencephalograms (EEG) revealed characteristic periodic complexes in only 22 patients. Magnetic resonance imaging (MRI) scans were normal in 24 patients but showed characteristic anomalies in 21 patients, primarily consisting of white matter hyperintensity and cortico-subcortical atrophy.
SSPE is not rare in early childhood. The latency period between virus infection and disease onset can be very short. Clinical, electroencephalographic, and radiological signs of the disease in young children may be atypical. Genetic studies are necessary to establish a genetic predisposition to the disease. Measles vaccination remains the most effective preventive measure against SSPE.
亚急性硬化性全脑炎（SSPE）是一种由麻疹病毒引起的中枢神经系统进行性炎症性神经退行性疾病，在近期麻疹流行后正经历显著的复发。本研究旨在调查幼儿期SSPE的病理学，并确定其临床、电生理和放射学特征。
本回顾性描述性研究在阿尔及尔纳菲萨·哈穆德大学医院儿科进行。研究纳入因亚急性神经疾病住院的2至6岁儿童。数据收集时间跨度为2020年1月1日至2022年12月31日的3年期间。
共检查了47例患者，其中37例为男孩，10例为女孩。平均年龄为45.9个月（范围：24至72个月）。值得注意的是，41例（87%）患者未接种麻疹疫苗，37例（80%）感染了麻疹病毒，其中31例（83.8%）发生在1岁以下儿童。SSPE在感染后约3年出现（范围：1至5年）。临床事件主要包括肌阵挛发作（26例）、强直阵挛发作（6例）、失张力发作（6例）和局灶性发作（3例）；25例患者出现运动障碍，28例患者出现认知下降。经常观察到脑炎表现，如意识或行为改变以及精神症状。脑电图（EEG）仅在22例患者中显示出特征性周期性复合波。24例患者的磁共振成像（MRI）扫描正常，但21例患者显示出特征性异常，主要包括白质高信号和皮质下皮质萎缩。
SSPE在幼儿期并不罕见。病毒感染与疾病发作之间的潜伏期可能非常短。幼儿期该疾病的临床、脑电图和放射学体征可能不典型。进行基因研究以确定该疾病的遗传易感性很有必要。麻疹疫苗接种仍然是预防SSPE最有效的措施。
