2005 issue 1

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Volume 14, issue 1

Original article

EEG and MRI abnormalities and the clinical course of subacute sclerosing panencephalitis (SSPE)

ANNA RUDNICKA1, Wanda Sobczyk1, Jerzy Kulczycki1, TERESA JAKUBOWSKA1, ROMANA BOGUSŁAWSKA2, Renata Poniatowska2, Waldemar Lechowicz3, Krystyna Niedzielska4
1. I Klinika Neurologii Instytutu Psychiatrii i Neurologii w Warszawie
2. Zakład Neuroradiologii Instytutu Psychiatrii i Neurologii w Warszawie
3. Zakładu Neuropatologii Instytutu Psychiatrii i Neurologii w Warszawie
4. Zakładu Neurofizjologii Klinicznej Instytutu Psychiatrii i Neurologii w Warszawie
Postępy Psychiatrii i Neurologii 2005; 14 (1): 19-24
Keywords: SSPE - sclerosing subacute panencephalitis, EEG and MRI correlation
Abstract

Objectives. Subacute sclerosing panencephalitis (SSPE) is a rare inflammatory and degenerative disorder of the CNS, following a systemic infection with a mutant measles paramyxovirus. The purpose of this study was to establish relationship between SSPE patients' clinical status and their EEG and MRI abnormalities.

Methods. Participants in the study were 30 SSPE patients in stage II of the disease, hospitalized in 1st Neurology Department in the years 1990-1996. All the patients received immunomodulatory treatment. In 21 patients EEG and MRI examinations were repeated at similar intervals over a 2-year period. The evaluation of their neurological status included the ability of verbal communication, orientation, as well as motor impairment and gait disturbance severity. In the neuropsychological assessment dementia severity was evaluated, as well as the degree of visuo-spatial functions impairment, constructional apraxia, visual agnosia and acalculia. T2-weighted MRI scans were analysed for the presence of elevated signal in the paraventricular white matter, and in cortex ofparticular lobes, as well as for the Evans index values and the volume of cortical atrophy. In the analysis of basic EEG activity of the brain an emphasis was laid on the occurrence of localized and ictal changes registered between typical Rademecker discharges.

Results. Over the two-year observation period no correlation was found between the degree of the SSPE patients' motor impairment and localization of their MRI abnormalities. The localization of inflammatory-degenerative lesions in MRI scans was found to be consistent with EEG abnormalities in 17 out of the 30 SSPE patients (i.e. in 56% of cases).

Conclusions. No clear-cut correlation was found between neurological symptomatology of patients with SSPE in stage II and localization of abnormalities in their EEG recordings and MRI scans.

Address for correspondence:
Dr Anna Rudnicka, I Klinika Neurologii Instytutu Psychiatrii i Neurologii, ul. Sobieskiego 9, 02-957 Warszawa, tel. (22) 4582548, fax: (22) 6426375, e-mail: kulczycki@ipin.edu.pl