Subacute Sclerosing Panencephalitis Presenting as Childhood Psychosis

Abstract

Two children, aged 9 and 10 years, 6 months, respectively, were referred to the Child Inpatient Unit of the Ness Ziona Government Psychiatric Hospital, Ness Ziona, Israel. Following an initial diagnosis of schizophrenia, routine EEG recordings demonstrated the presence of high voltage, slow wave complexes typical of subacute sclerosing panencephalitis (SSPE). This diagnosis was confirmed by elevated measles antibody titers in the serum and cerebral spinal fluid (CSF) with low CSF to serum ratio. Child psychiatrists are alerted to the importance of the DSM-III inclusionary and exclusionary criteria of schizophrenia in the differential diagnosis of childhood schizophrenia and organic psychoses, such as SSPE. Possible predilection of the SSPE demyelinative process to dopamine pathways in cases with coprolalia and psychosis is discussed. © 1987, The American Academy of Child and Adolescent Psychiatry. All rights reserved.