Psychiatric manifestation of SSPE.

摘要

SIR: Subacute sclerosing panencephalitis (SSPE) is a slowly progressive disorder that is typically seen in children and adolescents and has an invariably fatal outcome.1 Subacute sclerosing panencephalitis (SSPE) has been reported from all parts of the world, but in the West it is considered a rare disease with fewer than 10 cases per year reported in the United States.2 Few reports exist of SSPE initially presenting with psychiatric symptoms. We would like to report a child who initially presented to a psychiatry clinic and was later diagnosed with SSPE.Case ReportA 13-year-old boy with no family history of any psychiatric or neurological illness presented to the neurology outpatient clinic with difficulty in walking. The boy was apparently well about 2 months prior when the parents noticed that the child had become unusually quiet and withdrawn. He began to show less interest in his studies and refused to meet his friends, confining himself to his house most of the day. The usual cheerfulness andnaughtiness of the child had disappeared and he showed little inclination for talking to his parents and siblings. On a few occasions his parents found him crying without any particular reason. The patient also started having difficulty in memorizing his schoolwork and finishing his homework began to take longer. A month later the patient would laugh without any particular reason and would start crying when he was questioned. These rapid changes of mood made the parents seek a psychiatric consultation and he was diagnosed with having major depression and was prescribed fluoxetine, 20mg/day, by the psychiatrist. The boy developed difficulty in walking and needed support to walk a week later.