Epilepsy in children with subacute sclerosing panencephalitis.
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...Developed countries such as USA have reported an incidence of 6.5–11 cases per 100,000 acute measles infections.12 European countries like Turkey have reported an incidence of 2.2 cases per million in their population.16 Developing countries like Pakistan have reported an estimated incidence of 10 cases per million in their population.17 The highest rate that has ever been reported is from Papua New Guinea, which is 51 cases per one million during 2007–2009.18 Although there is no gender predisposition, but SSPE has been seen more commonly in boys.19 The risk of SSPE is higher if the onset of measles is at a younger age, in low socioeconomic class, in cases with low parental education and large family size.4 The clinical course is characterized by progressive cognitive decline and behavior changes followed by focal or generalized seizures as well as myoclonus, ataxia, visual disturbance, and later vegetative state.20,21 Patients suffering from SSPE die within few years of initial clinical presentation although there have been rare case reports of spontaneous remission.20 Epilepsy has been reported in one-third of the patients with SSPE.22 Jabbour et al23 have divided the clinical manifestations into four stages....
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...Although the number of countries with measles vaccine 1 coverage of >90% has risen between 2010 and 2015, we are still a long way from a global measles eradication.37 Pediatric Health, Medicine and Therapeutics 2018:9submit your manuscript | www.dovepress.com Dovepress Dovepress 70 Jafri et al Supportive treatment including management of seizures and other complications is the mainstay.11 Divalproate sodium is one of the common antiepileptics employed.38 There are no standard treatment protocols for the treatment of SSPE....
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...Neuroimaging may be helpful but is not characteristic of SSPE....
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...Ketogenic diet has also been tried; it was found to temporarily reduce the myoclonic jerks.40 Steroids and intravenous immunoglobulin are no longer recommended for the treat- ment of SSPE....
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...Acute complications include otitis media, pneumonia, diarrhea, and postinfectious encephalitis.5 Neurologi- cal complications of measles involve post-measles encephalitis, measles inclusion body encephalitis, transverse myelitis, and SSPE.6 The risk of serious complications and death is increased in children younger than 5 years and adults older than 20 years.7 This disease is preventable, and immunization against measles via live attenuated vaccine has been available for more than 45 years.8 SSPE usually occurs 7–10 years after measles infection, but the latency varies from 1 month to 27 years.9 A shorter latency has been reported in intrafamilial cases of SSPE as well as in children who were affected at an earlier ( 2 years) age such that the incidence was 18/100,000 in children younger than 5 years and 1.1/100,000 in those children with measles after 5 years.10,11 It is caused by the cerebral involvement of the Correspondence: Shahnaz H Ibrahim Department of Pediatrics and Child Health, Aga Khan University, Stadium Road, PO Box 3500, Karachi, Pakistan Tel +92 21 3486 4732 Fax +92 21 3493 2095 Email shahnaz.ibrahim@aku.edu Pediatric Health, Medicine and Therapeutics 2018:9submit your manuscript | www.dovepress.com Dovepress Dovepress 68 Jafri et al measles virus, which causes destruction of the neurons....
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31 citations
Cites background from "Epilepsy in children with subacute ..."
...Levetiracetam is reported to have mild improvement in myoclonus.(45) Improvement in myoclonus with carbamazepine is also reported....
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References
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