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About the Authors

Marzhan Yensebayeva – resident neurologist of Astana Medical University, Astana, Kazakhstan. This email address is being protected from spambots. You need JavaScript enabled to view it.

Altynshash Jaxybayeva – head of department of neurology, Astana, Kazakhstan. This email address is being protected from spambots. You need JavaScript enabled to view it.Ң; ORCID 0000-0002- 8927-7377

Nazira Dyussembek – resident neurologist of Astana Medical University, Astana, Kazakhstan. This email address is being protected from spambots. You need JavaScript enabled to view it.

Inkar Orazbayeva – resident neurologist of Astana Medical University, Astana, Kazakhstan. This email address is being protected from spambots. You need JavaScript enabled to view it.

Akerke Madikhan – resident neurologist of Astana Medical University, Astana, Kazakhstan. This email address is being protected from spambots. You need JavaScript enabled to view it.

Abstract

Subacute sclerosing panencephalitis is a late rare complication of measles infection in immunosuppressed and rarely in immunocompetent patients who have not developed an immune response, usually fatal within a few weeks or months. The risk of disease progression is also associated with age-dependent measles cases and is high in children below the age of immunisation (12 months). The clinical course of this condition is characterised by progressive cognitive and motor decline, seizures and eventually death. The recent decline in vaccination coverage in the Republic of Kazakhstan (Covid-19 pandemic, refusal to vaccinate, unwarranted medical withdrawals) has led to a recurrence of measles outbreaks, Kazakhstan leads the world in measles incidence at the beginning of 2024, which increases the risk of developing this disease in the near future. The authors present the case of a 5-year-old boy with subacute sclerosing panencephalitis who presented with progressive weakness, frequent loss of postural control, and multiple episodes of myoclonic seizures. In dynamics with deterioration of the condition and with the appearance of pyramidal and extrapyramidal disorders. Studying his history, he contracted measles at the age of 1 year (in 2018 - measles outbreak in the Republic of Kazakhstan). Examination showed increased measles antibody titre in serum and cerebrospinal fluid, on electroencephalogram generalised slowing with acute adhesions and symmetrical bilateral areas of increased T2 signal from white matter on magnetic resonance imaging of the brain, consistent with a probable diagnosis of subacute sclerosing panencephalitis. Although it has been reported that the combination of intrathecal interferon alpha (IFN-α) and daily oral administration of isoprinosine can halt the progression of the disease, but to date there is no treatment for this condition.

Keywords

Measles infection, progressive decline in cognitive and motor skills, seizures, vaccination, measles antibody titre, electroencephalography, intrathecal interferon alfa, isoprinosin, fatal outcome.

References

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