Subacute sclerosing panencephalitis (SSPE) is a progressive, debilitating, and deadly brain disorder related to measles (rubeola) infection.
Alternative NamesSSPE; Subacute sclerosing leukoencephalitis; Dawson's encephalitis
Causes, incidence, and risk factorsOrdinarily, the measles virus does not cause brain damage, but an abnormal immune response to measles or, possibly, certain mutant forms of the virus may cause severe illness and death. This leads to brain inflammation (swelling and irritation) that may last for years.
SSPE has been reported in all parts of the world, but in western countries it is considered a rare disease.
Fewer than 10 cases per year are reported in the United States, a dramatic decrease that followed the nationwide measles immunization program. However, in some countries like India, over 20 cases of SSPE per million people are reported each year.
SSPE tends to occur several years after an individual has measles, even though the person seems to have fully recovered from the illness. Males are more often affected than females, and the disease generally occurs in children and adolescents.
SymptomsThere may be a history of measles in an unvaccinated child. A physical examination may reveal:
The following tests may be performed:
No cure for SSPE exists. However, certain antiviral drugs may slow the progression of the disease.
Expectations (prognosis)Persons with this disease frequently die 1 to 2 years after diagnosis, but some may survive for longer periods. The condition is always deadly.
ComplicationsPrior to death, there may be:
Call your health care provider if your child has not completed their scheduled vaccines. The measles vaccine is included in the MMR vaccine.
PreventionImmunization against measles is the only known prevention for SSPE. The measles vaccine has been highly effective in reducing the numbers of affected children.
Measles immunization should be done according to the recommended American Academy of Pediatrics and Centers for Disease Control schedule. See: MMR immunization
ReferencesMaldonado YA. Rubeola virus (measles and subacute sclerosing panencephalitis). In: Long SS, Pickering LK, Prober CG, eds. Principles and Practice of Pediatric Infectious Diseases. 2nd ed. Philadelphia, Pa: Elsevier Churchill Livingstone; 2003:chap 227.
Subacute sclerosing panencephalitis (SSPE) is a progressive, debilitating, and deadly brain disorder related to measles (rubeola) infection.
Alternative NamesSSPE; Subacute sclerosing leukoencephalitis; Dawson´s encephalitis
Causes, incidence, and risk factorsOrdinarily, the measles virus does not cause brain damage, but an abnormal immune response to measles or, possibly, certain mutant forms of the virus may cause severe illness and death. This leads to brain inflammation (swelling and irritation) that may last for years.
SSPE has been reported in all parts of the world, but in western countries it is considered a rare disease.
Fewer than 10 cases per year are reported in the United States, a dramatic decrease that followed the nationwide measles immunization program. However, in some countries like India, over 20 cases of SSPE per million people are reported each year.
SSPE tends to occur several years after an individual has measles, even though the person seems to have fully recovered from the illness. Males are more often affected than females, and the disease generally occurs in children and adolescents.
SymptomsThere may be a history of measles in an unvaccinated child. A physical examination may reveal:
The following tests may be performed:
No cure for SSPE exists. However, certain antiviral drugs may slow the progression of the disease.
Expectations (prognosis)Persons with this disease frequently die 1 to 2 years after diagnosis, but some may survive for longer periods. The condition is always deadly.
ComplicationsPrior to death, there may be:
Call your health care provider if your child has not completed their scheduled vaccines. The measles vaccine is included in the MMR vaccine.
PreventionImmunization against measles is the only known prevention for SSPE. The measles vaccine has been highly effective in reducing the numbers of affected children.
Measles immunization should be done according to the recommended American Academy of Pediatrics and Centers for Disease Control schedule. See: MMR immunization
ReferencesMaldonado YA. Rubeola virus (measles and subacute sclerosing panencephalitis). In: Long SS, Pickering LK, Prober CG, eds. Principles and Practice of Pediatric Infectious Diseases. 2nd ed. Philadelphia, Pa: Elsevier Churchill Livingstone; 2003:chap 227.
Beckham JD, Tyler KL. Encephalitis. In: Mandell GL, Bennett JE, Dolin R, eds. Principles and Practice of Infectious Diseases. 7th ed. Philadelphia, Pa: Elsevier Churchill Livingstone; 2009:chap 87.
Reviewed ByReview Date: 07/26/2010
Neil K. Kaneshiro, MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
Subacute sclerosing panencephalitis (SSPE) is a long-lasting (chronic) infection of the central nervous system that causes inflammation of the brain. The infection is caused by an altered form of the measles virus.
As SSPE is almost always fatal, emphasis is placed upon maintaining comfort, rather than rehabilitation.
The disease progresses so that the individual becomes increasingly dependent, ultimately becoming bedridden and unaware of his or her surroundings.
Initial symptoms include a change in behavior, irritability, memory loss, and difficulty in forming thoughts and solving problems.
It is most common among people who had measles infection prior to the age of two years.
Called subacute sclerosing panencephalitis, this is a slowly progressing, smoldering swelling and destruction of the entire brain.
Experts believe this condition is a form of measles encephalitis (swelling of the brain), caused by an improper response by the immune system to the measles virus.
Symptoms include changes in personality, decreased intelligence with accompanying school problems, decreased coordination, involuntary jerks and movements of the body.
Blindness may develop, and the temperature may spike (rise rapidly) and fall unpredictably as the brain structures responsible for temperature regulation are affected. Death is inevitable.
The disease is caused by the reactivated form of a mutated measles virus. The inactive form of the virus can be present in the body for up to 10 years following the initial bout of measles before the symptoms of SSPE develop.
Children and young adults are primarily affected with SSPE. Males are also more affected than females, with a male-to-female ratio of 4:1. Those in rural areas are much more susceptible.
SSPE develops when the measles virus, which is still present but is in an inactive (or latent) form, is reactivated. The appearance of symptoms typically leads to a disease that last from one to three years.