A Close Look at EEG in Subacute Sclerosing Panencephalitis

• DOI: 10.1097/wnp.0b013e31829ddcb6
• Publication Date: 2013-08-03T09:59:47Z
• Authors: Nurhak Demir; Ozlem Cokar; Feray Bolukbasi; Veysi Demirbilek; Zuhal Yapici; Cengiz Yalcinkaya; Guher Saruhan Dir...; Sibel Yentur; Emel Onal; Gulden Yilmaz; Aysin Dervent
• Keywords: Male; Adolescent; Brain; Infant; Electroencephalography; Magnetic Resonance Imaging; Severity of Illness Index; 3. Good health; Diagnosis, Differential; Alpha Rhythm; 03 medical and health sciences; 0302 clinical medicine; Seizures; Child, Preschool; Humans; Female; Sleep Stages; Subacute Sclerosing Panencephalitis; Theta Rhythm; Child; Retrospective Studies

To define atypical clinical and EEG features of patients with subacute sclerosing panencephalitis that may require an overview of differential diagnosis.A total of 66 EEGs belonging to 53 (17 females and 36 males) consecutive patients with serologically confirmed subacute sclerosing panencephalitis were included in this study. Patient files and EEG data were evaluated retrospectively. EEGs included in the study were sleep-waking EEGs and/or sleep-waking video-EEG records with at least 2 hours duration. Cranial MRIs of the patients taken 2 months before or after the EEG records were included.Age range at the onset of the disease was 15 to 192 months (mean age: 80.02 months). Epilepsy was diagnosed in 21 (43%) patients. Among epileptic seizures excluding myoclonic jerks, generalized tonic-clonic type constituted the majority (58%). Tonic seizures were documented during the video-EEG recordings in four patients. Epileptogenic activities were found in 56 (83%) EEG recordings. They were localized mainly in frontal (58%), posterior temporal, parietal, occipital (26%), and centrotemporal (8%) regions. Multiple foci were detected in 26 recordings (39%). Epileptiform activities in the 39 (59%) EEGs appeared as unilateral or bilateral diffuse paroxysmal discharges.Recognition of uncommon clinical and EEG findings of subacute sclerosing panencephalitis, especially in countries where subacute sclerosing panencephalitis has not been eliminated yet, could be helpful in prevention of misdiagnosis and delay in the management of improvable conditions.