A 29-year-old pregnant woman with worsening left hemiparesis, encephalopathy, and hemodynamic instability: A case report of subacute sclerosing panencephalitis

Reis, Gerald F.; Ritter, Jana M.; Bellini, William J.; Rota, Paul A.; Bollen., Andrew

doi:10.5414/NP300843

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A 29-year-old pregnant woman with worsening left hemiparesis, encephalopathy, and hemodynamic instability: A case report of subacute sclerosing panencephalitis

Published Date:

2015 Sep-Oct

Publisher's site:

http://dx.doi.org/10.5414/NP300843 New Site Icon

Source:

Clin Neuropathol. 34(5):258-266.

[PDF - 603.76 KB]

Details:

Personal Authors:

Reis, Gerald F. ; Ritter, Jana M. ; Bellini, William J. ; Rota, Paul A. ; Bollen., Andrew ;

Keywords:

[+]

Pubmed ID:

25943270

Pubmed Central ID:

PMC4627486

Description:

A 29-year-old pregnant woman developed progressively worsening encephalopathy, left hemiparesis, and hemodynamic instability over a 6-week period. Initial brain MRI and work-up for infectious and autoimmune causes were normal, although elevated IgG and oligoclonal bands were seen on analysis of the cerebrospinal fluid (CSF). After uncomplicated spontaneous delivery of a preterm healthy infant, her condition worsened. Repeat brain MRI demonstrated generalized volume loss and evidence of corticospinal tract degeneration. She underwent a brain biopsy, which showed characteristic viral inclusions of the type seen in subacute sclerosing panencephalitis (SSPE). The diagnosis was confirmed by immunohistochemistry and electron microscopy, and additional CSF analysis also showed markedly elevated IgG titer for measles. Sequence analysis of the nucleoprotein gene N-450 demonstrated a close relationship to the sequences of viruses in genotype D7. This case documents an ~ 6-month progression to death of SSPE in a pregnant woman.

Document Type:

Journal Article

Collection(s):

CDC Public Access

Funding:

CC999999/Intramural CDC HHS/United States

Supporting Files:

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