Subacute Sclerosing Panencephalitis: Impact on Public Health, Current Insights, and Future Perspectives

Abstract

Background: Subacute Sclerosing Panencephalitis (SSPE) is a rare complication of the measles infection. SSPE is a chronic disease of the central nervous system (CNS) that causes encephalitis, leading to the demyelination of neurons in the brain. It affects the brain in 9 months or less and hence subacute, causing encephalitis and lesions in the entire brain, so the term panencephalitis is used.

Methods: A comprehensive literature search was conducted using the databases PubMed and Google Scholar starting in April 2024, and all relevant articles were extracted for this review.

Results: A recent surge in SSPE cases in developed countries has been reported. This has been attributed to reduced vaccination, aggravated by misinformation and a decline in immunization after the COVID-19 pandemic. SSPE is a progressive and relatively rare neurological complication of measles, which almost always results in a vegetative state followed by death. It typically presents 10 years following exposure to measles. Manifestations of SSPE are divided into four stages that range from general personality changes to coma. Complications include ocular pathology and eventual blindness, as well as psychiatric illnesses. Treatment options for SSPE include symptomatic control with antiepileptic drugs, interferon combined treatment, vitamin A, ribavirin, and a ketogenic diet for disease modification.

Conclusion: The only prevention for SPPE is through vaccination. Several collaborative efforts have been made with WHO to improve surveillance and increase vaccination, but still many challenges prevail. Better prevention strategies and improved treatment outcomes can only be achieved by enhancing healthcare access, improving public awareness, analyzing community-based data, and studying the genetic and molecular associations of measles and SSPE.

Keywords: SSPE; antiviral agents; measles resurgence; neurological disorder.

FIGURE 1

Pathogenesis of subacute sclerosing panencephalitis.

FIGURE 2

Genetic predisposition of SSPE.