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Subakut sklerosierende Panenzephalitis nach Masernexposition im Säuglingsalter

Subacute sclerosing panencephalitis following exposure to measles in babyhood

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Zusammenfassung

Hintergrund

Die subakut sklerosierende Panenzephalitis (SSPE) ist eine letal verlaufende Komplikation der Maserninfektion. Da der erste Masernkontakt oft schon vor der ersten Impfung erfolgt, kommt es immer wieder zu Erkrankungsfällen. Wir berichten von 2 betroffenen Kindern mit unterschiedlichen klinischen Verläufen.

Kasuistiken

Beide Patienten hatten im ersten Lebensjahr Kontakt mit an Masern erkrankten Kindern. Im Verlauf wurden beide gemäß den STIKO-Empfehlungen geimpft. Im Schulalter traten erste Krankheitssymptome auf. Es entwickelte sich eine schwere Enzephalopathie. Nur bei einem der Patienten bestand nach Diagnosestellung noch die Möglichkeit einer immunmodulatorischen Therapie, die zu einer passageren klinischen Verbesserung führte.

Schlussfolgerung

Die SSPE bleibt auch bei Kindern mit erfolgter Masernimpfung eine mögliche Differenzialdiagnose der unklaren progredienten Enzephalopathie. Prävention besteht nur in der konsequenten Immunisierung aller Kinder gegen Masern, um eine Minimierung der Ansteckungsgefahr, v. a. im ersten Lebensjahr, zu erreichen.

Abstract

Background

Subacute sclerosing panencephalitis (SSPE) is a lethal complication of measles virus infection. A risk factor for developing SSPE is measles exposure preceding the first vaccination. We report on two cases of SSPE with different clinical courses.

Case presentation

Both patients acquired an inapparent measles infection during their first year of life. They were vaccinated according to the current national recommendations. On reaching school age, early symptoms of SSPE were apparent and severe encephalopathy developed. Necrotizing chorioretinitis was observed in one of the patients. Only one patient was able to receive immunomodulatory treatment which induced transient clinical improvement.

Conclusion

SSPE should always be considered as a differential diagnosis in progressive encephalopathy in childhood. The disease can only be prevented by consistent measles vaccination in all children to minimize the risk of infection.

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Authors and Affiliations

  1. Abteilung Kinderheilkunde V, Pädiatrische Neurologie, Epilepsiezentrum, Universitätsklinik für Kinder- und Jugendmedizin Heidelberg, Im Neuenheimer Feld 153, 69120, Heidelberg, Deutschland

    A. Allmendinger, N. Wolf & F. Ebinger

  2. Abteilung Kinderheilkunde IV, Neonatologie, Universitätsklinik für Kinder- und Jugendmedizin Heidelberg, Heidelberg, Deutschland

    C. Doege

  3. Epilepsieklinik für Kinder und Jugendliche, Epilepsiezentrum Kork, Kehl-Kork, Deutschland

    H. Brückner

  4. Neuroradiologie, Neurologische Klinik, Universitätsklinikum Heidelberg, Heidelberg, Deutschland

    C. Stippich

  5. Institut für Virologie und Immunbiologie, Universität Würzburg, Würzburg, Deutschland

    B. Weißbrich

  6. Zentrum für Neuropathologie und Prionforschung, Ludwig-Maximilians-Universität München, München, Deutschland

    S. Roeber

  7. Abteilung Virologie, Hygiene-Institut, Universitätsklinikum Heidelberg, Heidelberg, Deutschland

    S. Parthe-Peterhans

Authors
  1. A. Allmendinger
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  2. C. Doege
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  3. N. Wolf
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  4. H. Brückner
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  5. C. Stippich
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  6. B. Weißbrich
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  7. S. Roeber
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  8. S. Parthe-Peterhans
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  9. F. Ebinger
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Corresponding author

Correspondence to A. Allmendinger.

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Allmendinger, A., Doege, C., Wolf, N. et al. Subakut sklerosierende Panenzephalitis nach Masernexposition im Säuglingsalter. Monatsschr Kinderheilkd 157, 55–60 (2009). https://doi.org/10.1007/s00112-008-1820-x

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  • DOI: https://doi.org/10.1007/s00112-008-1820-x

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