An initial MRI picture of limbic encephalitis in subacute sclerosing panencephalitis

Background: Subacute sclerosing panencephalitis (SSPE) is a rare and severe long-term complication of measles. Hallmarks of this entity include progressive cognitive decline, myoclonia, a generalized periodic pattern on EEG and deep white matter abnormalities on MRI. However, imaging can be normal in early stages. Aim: We report herein the case of a previously healthy 13-years-old girl with an unusual radiological presentation. Results: She presented with unilateral myoclonia, cognitive decline with memory impairment and a first brain MRI with swelling of both hippocampi mimicking limbic encephalitis. Measles antibodies were positive in CSF and the EEG showed slow periodic complexes. Conclusion: This unusual radiological presentation has never been described in SSPE. Relationship between virus and limbic system are discussed. (C) 2011 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.