Subject(s)
Catatonia/etiology , Catatonia/virology , Dengue/complications , Adolescent , Humans , MaleSubject(s)
Adenovirus Infections, Human/complications , Catatonia/drug therapy , Hypnotics and Sedatives/therapeutic use , Limbic Encephalitis/complications , Propofol/therapeutic use , Adenovirus Infections, Human/cerebrospinal fluid , Adenovirus Infections, Human/diagnosis , Anxiety Disorders/complications , Benzodiazepines/therapeutic use , Bone Marrow Transplantation , Catatonia/diagnosis , Catatonia/virology , Diagnosis, Differential , Fatal Outcome , Female , Herpesvirus 6, Human/isolation & purification , Humans , Hypnotics and Sedatives/pharmacology , Immunocompromised Host , Leukemia, Prolymphocytic, T-Cell/immunology , Leukemia, Prolymphocytic, T-Cell/surgery , Limbic Encephalitis/diagnosis , Limbic Encephalitis/virology , Middle Aged , Propofol/pharmacology , Psychomotor Agitation/diagnosis , Tacrolimus/bloodABSTRACT
Subacute sclerosing panencephalitis (SSPE) is a rare chronic, progressive encephalitis that affects primarily children and young adults, caused by a persistent infection of immune-resistant measles virus. Diagnostic hallmarks include widespread cortical dysfunction on EEG, myoclonus, white matter abnormalities on neuroradiological examination and the presence of IgG anti-measles antibodies in the cerebrospinal fluid. We present the first case of SSPE with signs of peripheral nerve hyperexcitability, observed as extra discharges following the compound motor action potential at motor nerve stimulation. In addition we demonstrate the importance of SSPE in the differential diagnosis of adult patients with psychiatric and neurological symptoms.
Subject(s)
Peripheral Nerves/physiopathology , Peripheral Nerves/virology , Peripheral Nervous System Diseases/diagnosis , Peripheral Nervous System Diseases/virology , Subacute Sclerosing Panencephalitis/complications , Subacute Sclerosing Panencephalitis/diagnosis , Action Potentials/physiology , Adult , Antiviral Agents/therapeutic use , Brain/pathology , Brain/physiopathology , Brain/virology , Catatonia/pathology , Catatonia/physiopathology , Catatonia/virology , Diagnosis, Differential , Disease Progression , Electrodiagnosis , Fatal Outcome , Female , Humans , Inosine Pranobex/therapeutic use , Magnetic Resonance Imaging , Measles/complications , Neural Conduction/physiology , Peripheral Nervous System Diseases/physiopathology , Persistent Vegetative State/pathology , Persistent Vegetative State/physiopathology , Persistent Vegetative State/virology , Subacute Sclerosing Panencephalitis/physiopathology , Treatment FailureABSTRACT
A 13-year-old female is described with presumed viral encephalitis, who developed progressive catatonia, agitation, and autonomic dysfunction. The diagnosis of malignant catatonia was made, and the patient improved with electroconvulsive treatment. This article discusses features, causes, differential diagnosis, and treatment of malignant catatonia. In children with this syndrome, electroconvulsive treatment should be considered.
