Rinsho Shinkeigaku (Clinical Neurology)

Case Report

A case of acute measles encephalitis with periodic synchronous discharge on electroencephalography

Kensho Okamoto, M. D. and Bungo Okuda, M. D.

Department of Neurology, Ehime Prefectural Central Hospital

A 18-year-old man was diagnosed as having meales on the basis of cutaneous and mucosal eruption and high grade fever on May 10, 2001. Six days after the skin eruption, the patient developed general convulsion (day1). He was admitted to our hospital because of status epilepticus. We made a diagnosis of acute measles encephalitis, based on the clinical features and pleocytosis with an increase in protein in the cerebrospinal fluid. Under artificial ventilation and sedation, he received intravenous immunoglobulin and dexamethasone. Electroencephalography (EEG) on day 4 revealed periodic synchronous discharge (PSD). Significant elevation of antibody titer for measles virus was found in the serum, but not in the cerebrospinal fluid. Polymerase chain reaction method did not show viral genes of measles virus, herpes simplex virus and herpes zoster virus. Serial EEG studies demonstrated a decrease in PSD, followed by irregular spike-wave complexes within 20 days. He recovered completely one month after the onset. It should be kept in mind that PSD can emerge on EEG in the early stage of acute measles encephalitis.

(CLINICA NEUROL, 42: 167|170, 2002)
key words: acute measles encephalitis, periodic synchronous discharge, electroencephalography, status epilepticus

(Received: 25-Dec-01)