Measles virus infection and subacute sclerosing panencephalitis

Abstract

Measles virus can cause two acute neurological disorders: acute infectious encephalitis and postinfectious autoimmune encephalitis, each with a risk of about 1 in 1,000 measles cases. Two other rare neurological problems manifest after a latent period: subacute measles encephalitis occurring in immunocompromised individuals, and subacute sclerosing panencephalitis (SSPE) in immunocompetent hosts. SSPE develops 1-10 years after measles infection; it is usually progressive and fatal. Mental and behavioral changes, myoclonia, and ataxia are typical initial manifestations. The diagnosis is based on the demonstration of intrathecal antimeasles virus immunoglobulin G synthesis. Pathological examination of brain biopsy or autopsy material demonstrates inflammation, neuronal loss, gliosis, demyelination, and typically, inclusion bodies containing measles virus antigens or RNA. Treatment with inosiplex and interferons may induce temporary stabilization or remission in about 30-35 % of the cases. Immunization against measles virus and maintenance of immunization rates above 90 % in the population are of extreme importance for the prevention of these debilitating or fatal disorders.